bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-8 Developmental Cognitive Phenotypes in First-Episode Psychosis and Longitudinal Cognitive Change Following Antipsychotic Treatment
Authors: Gotra Milena Y , Khalid Elmma , Dykins Madison M , Hill Scot K 
Published: August 2021

Abstract

Objective
The present study applied a developmentally based subgrouping procedure previously examined in chronic psychosis patients to a sample of first-episode psychosis (FEP) and examined change in cognition following treatment with antipsychotic medication.

Method
Medication naïve FEP patients (n = 119; age = 27.96; 63.9% male; 62.2% White, 32.8% Black, 5.0% Other) recruited during initial hospitalization were categorized into groups based on 1) estimated premorbid intellectual ability and 2) the discrepancy between predicted (modeled on 151 healthy controls) and current cognitive ability. Consistent with findings from chronic psychosis samples, groups were characterized as Preserved (n = 46; average premorbid, no discrepancy), Deteriorated (n = 44; average premorbid, significant discrepancy), and Compromised (n = 29, low premorbid and current cognitive ability). A mixed analysis of variance was used to examine change in a composite cognitive score derived from a comprehensive neuropsychological battery at baseline, 6 weeks, and 12 months.

Results
There was a significant group by time interaction [Figure 1; F(5.4142.4) = 2.81, p = 0.02] in which the Preserved group performed similar to healthy controls across all time points, the Compromised group demonstrated stable deficits after treatment, and the Deteriorated group diverged from the Compromised group at 6 weeks and 12 months.

Discussion
There is considerable cognitive heterogeneity in FEP at baseline and after initiation of antipsychotic medication. Findings of cognitive improvement in the Deteriorated group after treatment initiation suggests a differential response to antipsychotic medications that was not found in the Compromised or Preserved groups. Future work may benefit from examining medication and symptom severity as potential factors contributing to the unique change observed in the Deteriorated group.
A-86 Reactive Attachment Disorder in Adulthood: A Neuropsychological Perspective
Authors: Keniston Alyssa , Lewandowski Alan , Briggs Katelyn , Whynot Delaney 
Published: August 2021

Abstract

Objective
The sequelae of poor attachment and trauma on psychological and social functioning is well documented, however, this complex relationship applied to a neuropsychological profile is less understood. The current case uses a neuropsychological assessment to further understand the brain-behavior relationship in a case of poor maternal attachment, multiple traumas, psychiatric comorbidities, and poor social adaptation.

Method
Patient is a 22-year-old, right-handed, Eastern European woman with fetal alcohol and infant toxic mold exposure, failure to thrive, maternal neglect, adoption and relocation to the United States (age four), posttraumatic stress disorder (PTSD; multiple reported sexual traumas and bullying victimization), and depression. Referred for a neuropsychological evaluation for longstanding inattention, learning difficulties, being socially and emotionally withdrawn, and suspected Autism Spectrum Disorder (ASD).

Results
Data revealed average intellectual ability, dyscalculia, Attention Deficit Hyperactivity Disorder (ADHD), PTSD, and depression. A self-report measure of ASD revealed a strong perception of ASD, characterized by inability to read verbal cues or other’s emotions, and poor communication and self-expression, however, this diagnosis was not supported by formal assessment and behavioral observations; instead, it was determined a diagnosis of Reactive Attachment Disorder (RAD).

Conclusions
This case provides an example of the complex interplay of poor maternal–infant bonding coupled by adolescent trauma on adult attachment style and compromised social interactions. More specifically, the case addresses the poly-etiologic and neuropsychological impact of an insecure attachment style and trauma on self-perceptions of social and emotional withdrawal commonly seen in ASD. The case further stresses the overlapping presentations RAD, ADHD, learning disabilities, and psychiatric comorbidities.
A-91 Examining Symptoms of Depression in Traumatic Brain Injury Survivors Attention and Processing Speed Abilities
Authors: Schierholz Laura , Lopez-Hernandez Daniel W , Olmos Winter , Saravia Sarah , Budding Deborah , Smith Kristina E , Edry Loren , Muñoz Isabel , Nordberg Bethany A , Baez Abril J , Hovda David A , Vespa Paul , Woo Ellen , Hardy David J , Wright Matthew J 
Published: August 2021

Abstract

Objective
We examined the effects of depression in traumatic brain injury (TBI) and healthy comparison (HC) adults attention/processing speed (APS) performance.

Method
The sample size consisted of 44 acute TBI (ATBI), 32 chronic TBI (CTBI), and 59 HC participants. The Symbol Digit Modalities Test Oral (SDMT-O) and written (SDMT-W), Stroop Color Word Test word (SCWT-W) and color (SCWT-C), and Trail Making Test part A (TMT-A) were used to evaluate APS. The Hospital Anxiety and Depression Scale was used to assess depression (HADS-D).

Results
ANCOVAs, controlling for age revealed the HC group outperformed both TBI groups on the SDMT-W and SCWT-C, p &lt; 0.05, ηp2 = 0.08–0.24. We also found the CTBI group outperformed the ATBI group on the SDMT-W, p = 0.000, ηp2 = 0.24. Next, on the SDMT-O and TMT-A, the HC and CTBI groups outperformed the ATBI group, p &lt; 0.05, ηp2 = 0.10–0.15. On the SCWT-W, the HC group outperformed the ATBI group, p = 0.004, ηp2 = 0.08. Additionally, on HADS-D, both TBI groups reported higher symptoms of depression compared to the HC group, p = 0.002, ηp2 = 0.09. Pearson correlations revealed that for the CTBI group HADS-D correlated with SDMT-W, R2 = -0.36, p = 0.043. Finally, for the HC group HADS-D correlated with SDMT-O, R2 = -0.38, p = 0.003, and SCWT-C, R2 = -0.26, p = 0.045.

Conclusions
Overall, the ATBI survivors underperformed on all APS tasks compared to the HC group. Furthermore, we found the CTBI group outperformed the ATBI group on several APS tasks. Our data suggests that depressive symptoms are related more to APS tasks in CTBI survivors and HC compared to ATBI survivors.
A-93 Comorbidity or Concussion: Can we Tell the Difference?
Authors: Thomas Garrett A , Riegler Kaitlin E , Guty Erin , Bradson Megan L , Arnett Peter A 
Published: August 2021

Abstract

Objective
To evaluate athletes with comorbid mood disturbances at baseline (without recent concussion) compared to those without mood symptoms tested post-concussion. This study is predicated upon previous findings showing that athletes with comorbidity at baseline demonstrate greater neurocognitive impairment, and report greater symptomatology, than healthy controls. It is currently unclear how athletes with comorbidity at baseline compare to athletes post-concussion.

Method
119 college athletes completed objective neurocognitive testing, including measures of depression and anxiety. Athletes were separated into two groups: those with symptoms of comorbid anxiety/depression at baseline (n = 61,M = 35,F = 26) and those without such mood symptoms tested post-concussion (n = 58,M = 52,F = 6). All post-concussion athletes were tested within 14 days of injury. There were no overlapping athletes in these groups. Groups were compared on neurocognitive performance on mean z-score composites of Attention/Processing Speed (A/PS) and Memory.

Results
Regression results revealed that, on the A/PS composite, the Baseline Comorbid group (M = −0.15,SD = 0.64) did not differ significantly from the Post-Concussion Healthy Mood group (M = 0.05,SD = 0.62), t(117) = 1.75,p = 0.08, though there was a small effect size, d = 0.32. Additionally, on the Memory composite, the Baseline Comorbid Group (M = -0.12,SD = 0.69) did not differ from the Post-Concussion Healthy Mood group (M = -0.11,SD = 0.84), t(117) = 0.08,p = 0.94,d = 0.01.

Conclusions
These results suggest that athletes with comorbid anxiety/depression tested at baseline perform similarly to recently concussed athletes without mood disturbance, on objective neurocognitive measures. Thus, despite not experiencing recent injury, athletes with comorbidity present with similar neurocognitive profiles as athletes with recent concussions. These findings highlight the impact of comorbid mood disturbance on cognitive performance and demonstrate the importance of accounting for mood symptomatology when conducting neuropsychological assessments.
A-111 Ecological Momentary Assessment of Mood after Moderate to Severe Traumatic Brain Injury
Authors: Wilson Julianne , Rabinowitz Amanda R , Hart Tessa 
Published: August 2021

Abstract

Objective
In persons with moderate–severe traumatic brain injury (msTBI), we compared traditional measures of mood with dynamic measures of affect derived from ecological momentary assessment (EMA), for the purpose of validating the EMA indices and exploring their unique contributions to emotional assessment.

Method
23 community-dwelling participants with chronic msTBI were enrolled in a treatment trial for anxiety and/ or depression. At baseline, participants completed the Brief Symptom Inventory-18 Depression and Anxiety subscales (BSI-D, BSI-A) and the Environmental Reward Observation Scale (EROS), a measure of everyday pleasure and reward. EMA data, including the Positive and Negative Affect Scale (PANAS), were collected via smartphone 5 times daily for 7–14 days prior to treatment (M = 8.65; SD = 1.87). Spearman correlations tested associations between baseline BSI-D, BSI-A, and EROS scores with both overall means and temporal variability measures for positive and negative affect (PA, NA).

Results
Mean PA was significantly correlated with BSI-D (rho −0.60, p &lt; 0.05) and EROS (rho 0.72, p &lt; 0.01). Mean NA and affect variability measures were uncorrelated with baseline scores. NA mean and variability were intercorrelated (rho 0.87, p &lt; 0.001), but this was not the case for PA.

Conclusion
EMA measures of averaged positive affect showed robust relationships with retrospective measures of depression and environmental reward, providing support for the validity of EMA measures of PA, and for use of the EROS in msTBI. While negative findings must be interpreted with caution, the lack of association of affective variability with retrospective measures suggest a unique role for EMA in examining temporal dynamics of affect.
A-116 Neuropsychological Support for Use of Russell Posttraumatic Amnesia Classification of Traumatic Brain Injury
Authors: Cancelliere Andy E , Mascarenhas Melanie A 
Published: August 2021

Abstract

Objective
To compare neurocognitive outcomes between 3 traumatic brain injury (TBI) groups (mild, moderate, severe) across 3 TBI classification systems: Glasgow Coma Scale (GCS) and Russell (mild &lt;1 hour, moderate &lt;24 hours and severe &gt;24 hours) and the modified (mild &lt;24 hours, moderate &lt; one week and severe &gt; one week) posttraumatic amnesia (PTA) systems.

Method
Private practice archival data were reviewed for ambulance/hospital documentation of lowest GCS and PTA duration. Exclusion criteria included ESL and failed tests of engagement. Tests included WAIS, WMS, WRAT, Halstead Reitan etc.

Results
There were 91 patients (16 mild, 30 moderate and 45 severe); 45 were male. Mean age and education was 30.9 and 12.6. Russell PTA classification yielded significant differences (t-tests) between mild and moderate TBI on 8 of 46 tests/measures and 13 differences in moderate versus severe and 24 differences in mild versus severe TBI. Differences were always severe &gt; moderate &gt; mild impairment, with most in psychomotor speed, memory, working memory and executive/frontal functions consistent with TBI. The modified PTA classification yielded 2 significant differences between mild and moderate, 6 differences between moderate and severe and 22 differences between mild and severe TBI. GCS yielded 0 differences between mild and moderate, 7 differences between moderate and severe and 14 differences between mild and severe TBI. The modified PTA and GCS reduced moderate TBI numbers and some differences were opposite expectations.

Conclusions
Russell PTA was superior to the modified PTA system and GCS in separation/discrimination (without reversals) and maintenance of moderate TBI as a substantive category.
A-120 Comparison of Baseline and Post-Concussion ImPACT Performance in Spanish-English Bilingual and English Monolingual Athletes
Authors: Rogers Erick , Kuwabara Hana , Goodwin Grace , Moore Sara , Hopkins Nia , Goto Amber , Maietta Julia , Ross Staci , Kinsora Thomas , Allen Daniel 
Published: August 2021

Abstract

Objective
Research comparing English and Spanish administrations of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) have consistently found differences in performance on various cognitive composites. Few studies have examined the effect of bilingualism on baseline and post-concussion assessments. This study examined whether monolingual English-speakers (MO) and bilingual Spanish/English speakers (BI) differed in cognitive performance at baseline (BL) and post-concussion (PC).

Methods
Participants were selected from a larger database of high school athletes administered ImPACT in English at BL and PC. Participants included 86 BI athletes (Mage = 14.53; 65.10% male) and 86 MO athletes matched on age, gender, sport type, and probable concussion as defined by number of PC follow-up assessments (PCF; 0 vs. ≥1). To examine group differences and changes over time in cognitive composites, a general linear modeling approach was used with language and PCF as between-subjects factors and time as a within-subjects factor.

Results
There was a significant Language x Time x PCF interaction for Visual Memory (VM), Visual Motor Speed (VMS), and Reaction Time (RT). On VM and RT, MO with multiple PCF performed the worst at PC, while MO with 0 PCF performed the best at PC. On VMS, BI with 0 PCF performed the worst at BL.

Conclusion
Visual memory and reaction time were less affected in bilingual compared to monolingual athletes with probable concussion. However, at baseline, bilingual athletes had slower visual motor speed compared to monolingual athletes. Future research should focus on how bilingualism may serve as both a protective and risk factor for cognitive functioning after probable concussion.
A-125 The Impact of Bilingualism on Symbol Digit Modalities Test Performance Following Traumatic Brain Injury
Authors: Munoz Raelynn , Lopez-Hernandez Daniel W , Rugh-Fraser Rachel A , Sidhu Jasman , Litvin Pavel Y , Hernandez Juan P , Nordberg Bethany A , Bueno Alexis , Mangassarian Selina , Olmos Winter , Hardy David J , Vespa Paul , Plurad David , Hovda David A , Woo Ellen , Fuster Joaquin M , Budding Deborah , Wright Matthew J 
Published: August 2021

Abstract

Objective
Traumatic brain injury (TBI) survivors exhibit cognitive deficits. Research suggests that multilingualism can influence neurocognitive performance. We examined the effects of TBI and bilingualism/monolingualism on a test of attention and cognitive speed (i.e., Symbol Digit Modalities Test; SDMT).

Method
The sample consisted of 55 healthy comparison (27 Spanish-English bilinguals; 28 English-monolinguals), 34 acute TBI (14 Spanish-English bilinguals; 23 English-monolinguals), and 27 chronic TBI (13 Spanish-English bilinguals; 12 English-monolinguals) participants. Acute TBI participants were tested 6 months post-injury; chronic TBI participants were tested 12 months or more post-injury. A series of 3X2 ANOVAs were conducted to determine the effect of TBI and language on SDMT written and oral performance.

Results
ANOVAs revealed the healthy comparison group outperformed both TBI groups on SDMT written, p = 0.000, ηp2 = 0.21. Also, the healthy comparison and chronic TBI groups outperformed the acute TBI group on SDMT oral, p = 0.000, ηp2 = 0.13. Interaction effects emerged between TBI and bilingualism/monolingualism. On SDMT written and oral, acute TBI English-monolinguals outperformed acute TBI Spanish-English bilinguals; meanwhile, chronic TBI Spanish-English bilinguals outperformed chronic TBI English-monolinguals, p &lt; 0.05, ηp2 = 0.09–0.10.

Conclusion
The acute TBI group performed worse than healthy comparison adults on both SDMT tasks. Furthermore, the chronic TBI group demonstrated better SDMT oral abilities compared to the acute TBI group. Relative to monolinguals with TBI, our findings suggest better cognitive recovery of attention and cognitive speed in bilingual TBI participants. Future studies with larger sample sizes should examine if learning English first or second impacts Spanish-English bilingual TBI survivors’ SDMT performance compared to English-monolingual TBI survivors.
A-127 The Interplay of Social Perception and Psychiatric Symptoms in a Case of Traumatic Brain Injury
Authors: O'Hara John B , Young Kevin P 
Published: August 2021

Abstract

Objective
Acquired impairment in social perception (SP) is relatively common following moderate to severe traumatic brain injury (TBI), with up to 39% of these individuals experiencing deficient facial affect recognition. Formal assessment of SP is not common practice, despite evidence of this as a predictor of social functioning. We present the case of a 35-year-old, Caucasian male with new onset paranoid/delusional (P/D) thought processes in the context of prior TBI.

Method
The patient’s TBI (unknown severity) occurred 17 years prior and resulted in prolonged (&gt;1 year) hospitalization, followed by intensive rehabilitation services. He reported residual, stable difficulties with attention, processing speed, executive functioning, and memory. Post-TBI, he was living independently with few external supports. Following a traumatic encounter with a family member (nine months prior), the patient developed P/D thought processes and a marked decline in functioning, resulting in three psychiatric hospitalizations. Brain MRI (Figure 1) revealed encephalomalacia and gliosis in the bilateral inferior frontal lobes anteriorly, high frontoparietal lobes, and bilateral (L &gt; R) temporal lobes. Neuropsychology was consulted to clarify diagnosis/etiology and assess functional status.

Results
(Table 1). Evaluation results revealed non-amnestic memory impairment and variable language and processing speed. Performances on measures of SP revealed a notable weakness in the context of current intellectual performances.

Conclusions
This case highlights the importance of formally assessing SP in cases of TBI. Underlying SP difficulties in the context of a traumatic event may have increased vulnerability to psychiatric decompensation. Evaluation of SP allowed for enhanced understanding of the interplay between cognitive and psychiatric symptoms.
A-136 The Transfer of Cognitive Training to Real-World Functioning: Results of our First Six Pilot Subjects at Six-Month Follow-Up
Authors: Blake Jason A , Mitchell Brandon , McKay Staci , Uswatte Gitendra , Taub Edward 
Published: August 2021

Abstract

Objective
Currently, the majority of cognitive training research measures treatment efficacy using in-laboratory measures, with minimal focus on real-world treatment changes. This case series demonstrates the feasibility of transferring cognitive improvements from the laboratory into the everyday life setting.

Method
This case series includes 6 chronic post-stroke participants; mild to moderate cognitive impairment. The intervention combines cognitive training with behavioral techniques, known as the Transfer Package (TP). The TP involves components that target functionality on IADLs in the real-world. Performance on cognitively-based IADLs in the real world are measured pre-treatment, post, and 6-month follow-up. Measures of real-world ability are the: Canadian Occupational Performance Measure (COPM), Cognitive Task Activity Log (CTAL) and Inventory of Improved and New Abilities (INCA). In-laboratory measures included the D-KEFS and Timed IADL assessments.

Results
The real-world outcome measures used in this study were the COPM and two measures developed for this study, the CTAL and INCA. The mean change from pre to post on the COPM Performance Scale was 2.18 (SD = 1.33) and the mean change on the COPM Satisfaction Scale was 2.70 (SD = 1.27). The mean change on the CTAL was 1.96 (SD = 0.93). On the INCA, the mean number of improved real-world cognitive activities was 11.8 (SD = 4.9) and the mean number of new cognitive activities was 7.6 (SD = 3.9). Follow-up reported near-perfect retention on CTAL and continued improvement on the INCA. There were minimal changes on in-laboratory measures.

Conclusions
This case series provides a framework for achieving the transfer of cognitive training treatment effects in the real-world life situation by overcoming behavioral barriers to functioning.
A-15 PTSD Symptoms Are Related to Cognition Following Complicated Mild and Moderate TBI, but Not Severe and Penetrating TBI
Authors: Lippa Sara M , Brickell Tracey A , French Louis M , Lange Rael T 
Published: August 2021

Abstract

Objective
Despite the strong evidence suggesting post-traumatic stress disorder (PTSD) symptoms negatively impact cognition following mild traumatic brain injury (TBI), little is known about this relationship in more severe TBI. This study investigates the relationship between PTSD symptoms and cognitive performance following complicated mild, moderate, severe, and penetrating TBI.

Methods
Participants were 137 U.S. military service members and veterans (SMVs) with a history of complicated mild or more severe TBI prospectively enrolled in the Defense and Veterans Brain Injury Center (DVBIC)/Traumatic Brain Injury Center of Excellence (TBICoE) 15-Year Longitudinal TBI Study. Participants were divided into two groups: complicated mild/moderate TBI (n = 64) and severe/penetrating TBI (n = 73). Participants completed a neuropsychological assessment, including the PTSD Checklist-Civilian Version one year or more post-injury. Six neuropsychological composite scores and an overall test battery mean (OTBM) were considered. Participants who failed symptom validity tests were excluded. Hierarchical linear regressions were conducted evaluating neuropsychological performance.

Results
TBI severity (βs:-0.163 to −0.253, ps &lt; 0.04) and PTSD symptoms (βs:-0.189 to −0.212), ps &lt; 0.03) were related to neuropsychological performance in the overall sample. Within the severe/penetrating TBI group, PTSD symptoms were unrelated to cognitive performance. Within the complicated mild/moderate TBI group, PTSD symptoms were significantly related to processing speed (R2Δ = 0.080, β = −0.284, p = 0.016), immediate memory (R2Δ = 0.204, β = −0.453, p &lt; 0.001), delayed memory (R2Δ = 0.180, β = −0.426, p &lt; 0.001), executive functioning (R2Δ = 0.102, β = −0.319, p = 0.007), and the OTBM (R2Δ = 0.170, β = −0.413, p &lt; 0.001).

Discussion
PTSD symptom severity was significantly related to neuropsychological performance in SMVs with complicated mild/moderate TBI. PTSD symptoms should be considered when evaluating patients with a history of complicated mild to moderate TBI.