bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-15 Validity of the NIH Toolbox Cognitive Battery in a Healthy Oldest-Old 85+ Sample
Authors: Sims Sara A , Levin Bonnie , Rundek Tatjana , Cohen Ronald A , Alexander Gene , Visscher Kristina M 
Published: August 2021

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

Conclusions
Our findings provide additional evidence that published MVP cut-offs may be too lenient to adequately capture instances of noncredible performance and indicate an MVP Total score cut-off of ≤30 may be more appropriate for use with heterogeneous clinical populations.
A-40 The Neurocognitive and Behavioral Profile of an Adolescent with in-Utero Exposure to Alcohol
Authors: Smith Alphonso , Norris Courtney 
Published: August 2021

Abstract

Objective
Prenatal alcohol exposure can result in altered brain development that has detrimental effects on children and put them at increased risk for cognitive impairment, sensorimotor deficits, attention problems, behavioral issues, and social–emotional difficulties. Further, adolescents with neurodevelopmental disorders associated with in-utero exposure to alcohol require targeted academic and psychosocial support as they transition into adulthood which emphasizes the need for neuropsychological assessment.

Method
This case study presents on the neuropsychological profile of a 17-year-old male in the 11th grade who was exposed to alcohol in-utero and was diagnosed with fetal alcohol effects as a young child by his primary care physician.

Results
Neuropsychological testing revealed a broad range of impairments which included deficits in intellectual functioning (mild disability), adaptive functioning, language, academic achievement, attention, executive functioning, memory, fine/visuomotor skills, and social–emotional functioning.

Conclusions
Recommendations were made to modify his special education goals by targeting his functional academic skills, adaptive functioning, communication skills, and post-high school transition planning. Recommendations for behavioral interventions were given to his referring psychotherapist to aid in treatment planning. Information on vocational counseling and financial support for individuals with developmental disabilities were provided to the patient’s guardian as well. This case study illustrates the long-lasting neurocognitive and behavioral effects associated with in-utero alcohol exposure and the need for neuropsychological assessment during adolescence in order to reduce secondary issues (e.g., school problems, lack of mental health support, unemployment, and financial hardship) that can occur as these individuals move into adulthood.
A-43 Pediatric Infratentorial Anaplastic Ependymoma: A Case Study
Authors: Mason Sara , Harley Aikisha , Liu Kevin , Markiv Yelena 
Published: August 2021

Abstract

Objective
Ependymoma is the third most common malignant pediatric brain tumor and often presents posteriorly. Understanding of long-term outcomes of pediatric posterior fossa tumor and treatment is required to maximize developmental trajectory. This case illustrates cognitive correlates of pediatric posterior fossa tumor and treatment in an adolescent without cerebellar mutism or psychiatric co-morbidities. Repeated post-treatment assessments allowed for characterization of initial effects of treatment over time.

Method
The patient, diagnosed with an infratentorial anaplastic ependymoma at age 15, presented for initial neuropsychological evaluation status-post craniotomy, ventricular drain placement, posterior fossa tumor resection, radiotherapy, and chemotherapy. Recovery was complicated by cranial nerve palsies, dysphasia, and dysarthria. Repeat assessment was conducted 13 months later. Interim treatment included three cycles of maintenance chemotherapy. Aside from moderate dysarthria, the patient denied cognitive concerns each evaluation.

Results
Attention, working memory, planning, problem solving, language, reasoning, and motor speed/dexterity were within expectations at initial evaluation without deficits in academic or socioemotional functioning. Visual encoding/organization and processing speed were below expectations. Findings at follow-up revealed marked declines in bilateral motor speed and dexterity.

Conclusion
Weaknesses in visual organization and motor functioning are consistent with expected neurocognitive correlates of pediatric posterior fossa tumor and resection, particularly with cerebellar involvement. Additional motoric slowing is associated with white matter changes and often observed after cancer treatment. Longitudinal follow-up illustrated the potential for neurocognitive resilience in pediatric posterior fossa tumor treatment in the face of significant motor dysfunction. Nevertheless, late-effects of radiation and chemotherapy may manifest in early adulthood and must be monitored in pediatric patients.
A-44 Implications of the Heart Rate Variability Power Spectrum on the Relationship between Prenatal Anxiety Exposure and Child Anxiety in 5-Year-Olds
Authors: Ginalis Christine L , Zaki Jeenia , Bedoya Ana Cristina , Nomura Yoko 
Published: August 2021

Abstract

Objective
To assess the role of the heart rate variability (HRV) in the relationship between prenatal anxiety exposure and subsequent child anxiety levels.

Methods
A longitudinal study of mother–child dyads (subsample of 89) measured maternal anxiety during the second trimester of pregnancy (self-reported via STAI-S) and subsequent child anxiety (maternal-reported via BASC-3) and baseline autonomic physiological measures (high and low frequency band of HRV power spectrum) at 5-years-old. Mediation analysis was conducted to test whether child high and/or low frequency HRV mediates the relationship between prenatal anxiety and child anxiety.

Results
Prenatal anxiety predicted child anxiety (β = 0.137, p = 0.004) and high frequency HRV (β = −0.009, p &lt; 0.001), but not low frequency HRV (β = −0.002, p = 0.231). Mediation analysis using bootstrapping procedure revealed that high frequency HRV (β = 0.044, 95% CI [0.007, 0.085]), but not low frequency HRV (β = 0.0117, 95% CI [−0.007, 0.047]), mediated the relationship between prenatal anxiety and child anxiety. After controlling for high frequency HRV, prenatal anxiety was no longer associated with child anxiety (β = 0.0753, p = 0.148).

Conclusion
Results indicate that in-utero exposure to maternal anxiety influences the child’s high frequency but not low frequency HRV. Importantly, changes in only high frequency HRV from prenatal anxiety is driving the relationship between prenatal anxiety and child anxiety levels, indicating that maternal anxiety during pregnancy affects the development of the autonomic nervous system with long term effects on child emotional regulation. The results suggest that the high frequency portion of the HRV power spectrum should be assessed in a multidimensional model of fetal programming and subsequent mental health risk of the child.
A-48 Examining the Relationship between Ethnicity, Perceived Workload, and Acculturation on Cordoba Naming Test Performance
Authors: Munoz Isabel , Lopez-Hernandez Daniel W , Baez Abril J , Cervantes Raymundo , Munoz Raelynn B , Edry Loren , Schierholz Laura , Hernandez Juan P , Wright Matthew , Hardy David J , Fernandez Alberto L 
Published: August 2021

Abstract

Objective
Confrontation naming tests are used to examine an individual’s lexical retrieval. We examined the relationship of perceived workload and acculturation in three ethnic groups’ Cordoba Naming Test (CNT) performance.

Methods
The sample consisted of 32 Latinx, 11 Caucasians, and 10 Asian; all neurologically and psychologically healthy residents. All participants completed the CNT and subscales of the Abbreviated Multidimensional Acculturation Scale (AMAS) in English. AMAS was used to measure acculturation and the NASA-Task Load Index (NASA TLX) measured perceived workload.

Results
The CNT showed that the Caucasian group outperformed the Latinx group, p = 0.024, ηp2 = 0.14. However, the Latinx group reported better CNT performance compared to the Caucasian group, p = 0.023, ηp2 = 0.14. No differences were found between groups on the AMAS. Finally, we found a significant relationship between CNT and NASA-TLX subscales (i.e., performance, mental demand, effort, frustration, & overall perceived workload) in the Latinx group, r = −0.562 to −0.398, p &lt; 0.05.

Discussion
Results showed the Latinx group demonstrated worse CNT performance compared to the Caucasian group. To our knowledge, this is the first study to evaluate confrontation naming performance in an ethnically diverse sample. Furthermore, we found the Latinx group reported a higher perceived performance on the CNT compared to Caucasians. Our results indicated a relationship between CNT performance and perceived workload in our Latinx sample as opposed to the Caucasian and Asian groups. Future research is needed with a larger sample size; moreover, additional research should investigate interactions between perceived workload, acculturation, and other cultural variables (e.g., bilingualism) in the interpretation of test performance in diverse ethnic groups.
A-54 The Relationship between Age and MMSE Performance Amongst Individuals with Heart Failure
Authors: Nemanim Natasha , Lackey Nicholas , Connors Eric J , Hauson Alexander O , Pollard Anna , Barlet Brianna , Walker Alyssa , Sarkissians Sharis , Stelmach Nicholas , Flora-Tostado Christopher 
Published: August 2021

Abstract

Objective
A previous meta-analysis assessing the impact of heart failure (HF) on cognition found the HF group performed more poorly than the healthy control (HC) on global cognition measures. The study observed a medium effect and moderate heterogeneity when using the Mini-Mental Status Examination (MMSE) to measure HF’s impact on global cognition. The current meta-regression explores whether the mean age of the HF group moderates performance on the MMSE when comparing HF patients to HC.

Data Selection
Two researchers independently searched eight databases, extracted data, and calculated effect sizes as part of a larger study. Inclusion criteria were: (a) adults with a diagnosis of HF, (b) comparison of HF patients to HC, and (c) adequate data to calculate effect sizes. Articles were excluded if patients had other types of organ failure, the article was not available in English, or there was a risk of sample overlap with another included study. Twelve articles (HF n = 1166 and HC n = 1948) were included. The unrestricted maximum likelihood computational model was used for the meta-regression.

Data Synthesis
Studies included in the meta-regression evidenced a statistically significant medium effect size estimate with moderate heterogeneity (k = 12, g = 0.671, p &lt; 0.001, I2 = 80.91%). The meta-regression was statistically significant (slope = −0.023, p = 0.0022, Qmodel = 5.26, df = 1, p = 0.022).

Conclusions
Individuals with HF performed more poorly on the MMSE than HC. Larger effect sizes on the MMSE were observed in studies with participants who were younger compared to studies with participants who were older. Future research should continue to delineate the impact of age on global cognition in individuals with HF.
A-66 Neuropsychological Sequalae of SARS-CoV-2
Authors: Rivera Rita M , Carballea Denise 
Published: August 2021

Abstract

Objective
The purpose of this systematic review is to identify neuropsychological sequelae following infection of SARS-CoV-2.

Data Selection
A systematic search of the literature was conducted in 2021 using the keywords: neuropsychological symptoms, neuropsychological sequelae, neuropsychological manifestations, SARS-CoV-2, COVID-19, and coronavirus. The search conducted included a total of 6 databases: PsychNet, ProQuest, Taylor & Francis Online, EBSCOhost, Google Scholar, and PubMed Central. A total number of 25 articles were considered, and 8 of those articles were retained. Inclusion criteria consisted of peer-reviewed articles published in English between the years 2020 and 2021. Exclusion criteria consisted of articles not published in English and those that did not examine the neuropsychological symptoms following COVID-19 infection.

Data Synthesis
Literature examined reported that clinical observations of severe cases of COVID-19 infection were associated with the presence of neuropsychological symptoms. Post-infection of SARS-CoV-2, the following symptoms have been noted: severe executive dysfunction, fluctuations in attention and concentration, and instances of disorientation and confusion. Although etiological hypotheses have been made, there is still no consensus or treatment for the neuropsychological sequelae of COVID-19. Studies also reported that a significant risk factor for these individuals was the presence of premorbid psychological/psychiatric illnesses.

Conclusions
Patients who recover from severe COVID-19 can experience a multitude of neuropsychological manifestations. In some cases, these effects have been reported to be long-standing. Due to limited understanding regarding the nature and mechanism of action of SARS-CoV-2, it is difficult to pinpoint the cause, duration, treatment, and prognosis of neuropsychological symptoms of post-recovery patients.