bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-06 The Culturally Expressive and Responsive (CER) Supervision Model in Neuropsychology
Authors: Strutt A , MacDonald B , Stinson J 
Published: August 2019

Abstract

Objective
The competency-based movement within neuropsychology training programs has done much to create uniform standards of training and identify the “readiness” of trainees to progress to the next level. However, there is little research regarding best practices for development of a supervisory style. The successful progression from trainee to independent practitioner requires a training model that evolves, allowing for independence and collegiality, which includes knowledge expansion, changes in professional relationships and successful institutional navigation. Culture mediates interactions in the patient-doctor relationship, case conceptualization, and also within and between institutional frameworks; therefore, a supervision model should include a multicultural perspective at its core. Data Selection: An otherwise unrestricted multi-database search for “Neuropsychology Supervision” within the title of peer-reviewed journals yielded six results with publication years spanning 1999-2017. Only three specifically address models of supervision and only one is US-based (Stucky et al., 2010). Given then demographic shift estimated for 2050 (Passel & Cohn, 2008), there is a call to action to increase culturally competent neuropsychological services, including training and strengthening the student pipeline (Mindt Rivera et al., 2010). Data Synthesis: The proposed Model for Neuropsychology Supervision (Stucky et al., 2010) recommends supervision to be individually tailored, with both process-based and developmental approaches.

Conclusions
There is a strong need for clear supervision models designed specifically for neuropsychology that integrate culture at all levels of training. Authors propose the Culturally Expressive and Responsive (CER) Supervision Model in Neuropsychology. This is a framework for both trainees and professionals that provides a developmental approach integrating culture and the competency-based standards.
A-07 The Potential Impact of Nuclear History of Micronesia in Neuropsychological Functioning
Authors: Duke L , Gallahue C , Lin J , Shah D , Wu J , Wu V 
Published: August 2019

Abstract

Objective
As a result of 67 nuclear tests in the Marshall Islands between 1946 and 1958, inhabitants of Micronesia exposed to radiation exhibited chronic health issues and birth defects that persist to this day. This patient’s presentation may be an example of the continued residual impact of nuclear testing in Micronesia and demonstrates the importance of historical and biological factors when considering differential diagnoses.

Method
Patient is a six-year-old Micronesian male referred for assessment of psychological functioning. He was developmentally delayed since birth, exhibited unusual facial features, and previously diagnosed with Autism Spectrum Disorder (ASD). Presenting problems included speech delays, limited attention span, difficulty coping with challenges, narrow interests, impulsivity, difficulties interacting with peers, and toileting issues (i.e., defecating on the floor). Mother immigrated to Hawaii from Micronesia in 2006 and primarily speaks Chuukese. While pregnant, mother was on medications for diabetes, hospitalized with high blood pressure, and chewed tobacco daily. Patient experienced some difficulties during the neonatal period.

Results
Average nonverbal intelligence; moderately low receptive single word vocabulary; possible somatization, tendency to withdraw, and atypical behavior; problems with functional communication and daily living activities; and learning-related problems at school. Probability of autism within the Possibly/Very Likely range. Age-inappropriate projective drawings, with indications of potential genetic or developmental dysfunction.

Conclusions
Patient was diagnosed with ASD, with accompanying language impairment. Due to family history of radiation exposure in Micronesia and prenatal concerns, a rule out of other neurodevelopmental disorders and various genetic conditions were considered.
A-08 Aggressive Presentation of Attention Deficit Hyperactivity Disorder: A SPECT Study
Authors: Ailes E , Datoc A , Gilmore M , Golden C , Amen D , Willeumier K , Taylor D 
Published: August 2019

Abstract

Objective
Explore the effects of aggression in adults diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) on regional cerebral blood flow (rCBF).

Method
Participants were extracted from an archival de-identified SPECT database (n = 889,Mage = 36.73, 60.4% male, 71.6% Caucasian). Two groups were formed based on self-reported aggressive symptoms: low (below 25th percentile; n = 396) and high aggression (above 75th percentile; n = 435).

Results
Age was used as a covariate. One-way ANCOVA’s were conducted controlling for age (alpha = .01). Significant differences were found between groups in the left (F[1,829] = 5.755, ) and right (F[1,829] = 6.114) limbic regions, left basal ganglia (F[1,829] = 4.006, p = .046), left occipital (F[1,829] = 3.951,p = .047), and right parietal regions (F[1,829] = 4.341,p = .038). Discussion: Results revealed that individuals with ADHD and high aggression failed to have significantly different levels of rCBF in areas of the brain responsible for emotion regulation compared to those with low aggression. This study is the first to explore differences in rCBF in a sample of individuals with ADHD. It was hypothesized that higher activation in the limbic and basal ganglia areas was the process of experiencing highly emotional/distressing feelings and the process of acting upon these emotional experiences. However, SPECT failed to present as a reliable resource for identifying individuals with ADHD that have aggressive and impulsive tendencies in this study. Thus, it is suggested that clinicians use caution when using SPECT as a resource in identifying populations likely to engage in aggressive and highly dangerous acts (i.e., suicide/homicide). Further research is needed in using SPECT to identify ADHD populations which may be likely to engaged in aggressive and highly dangerous acts.
B-17 Examining Driving Abilities in Autistic Young Adults
Authors: Nemeth D , Chustz K 
Published: August 2019

Abstract

Objectives
A single white 27 year-old male with autism was referred for an evaluation of his neurocognitive skills for driver’s training competency. Typically, the following criteria are required for special needs individuals to be issued a driver’s license: 1) Must pass neuropsychologist evaluation, 2) Must be cleared by occupational therapist, and 3) must be approved by primary care physician; Schultheis presented a symposium on this topic at the International Neuropsychology Society meeting in Portland, Oregon in 2007. As driving is one of the primary methods of achieving independence in our society, most teens and young adults, regardless of diagnosis, strive to obtain a license.

Methods
This case presentation will profile the results of this individual’s neurocognitive driving skills. This neuropsychological evaluation included the Cognitive Behavioral Driver’s Inventory (CBDI).

Results
Significant results included: Average to low average intellectual skills, high average to average memory and attentional skills, weakness in math, multi-tasking perceptual motor difficulties, visual spatial/constructional difficulties, normal affective functioning, and positive personality profile. This individual had a “clearly failing” CBDI score of 91, with weaknesses in the following areas: Visual scrutiny and attention to detail, Visual motor coordination and fine motor speed, attention and concentration, rapid decision-making, distractibility, and mental flexibility, and consistency of performance. Although previously diagnosed with ADD, results of objective testing (TOVA) did not support this diagnosis.

Conclusions
Outpatient occupational therapy program to include visual spatial and rapid decision-making skills was recommended. Upon completion of this program, a re-administration of the CBDI is recommended.
B-20 Neuropsychological Profile in an Individual with Mitochondrial Encephalopathy, Lactic acidosis, and Stroke-like episodes (MELAS): A Case Study
Authors: Figueroa P , Barbeito C , Ireland S 
Published: August 2019

Abstract

Objective
Mitochondrial Encephalopathy, Lactic acidosis, and Stroke-like episodes (MELAS) is a rare and debilitating mitochondrial disease that affects bodily systems at the neurological level. The purpose of this study is to contribute to the paucity of research regarding the neuropsychological presentation and functional impact of MELAS.

Method
Mr. James is a 23-year-old male of Thai descent who initially presented with 2-3 days of headaches followed by generalized seizures and altered mental status. Over the course of one year, Mr. James experienced recurrent seizures with postictal confusion, and transient aura-like episodes. Patient was diagnosed with MELAS based off a combination of clinical findings, including magnetic resonance imaging (MRI) spectroscopy (SPECT) and molecular genetic testing. Extensive evaluation revealed persistent bilateral multifocal cortical/subcortical lesions, diffuse edema like signal and expansion involving the bifrontal, bitemporal, and bilateral subinsular cortices. Neuropsychological sequalae included physical, cognitive, and emotional changes from baseline.

Results
Mr. James was given a comprehensive neuropsychological battery in order to identify marked changes from his pre-morbid levels of neuropsychological functioning. Consistent with the literature, his profile revealed hallmark expressive and receptive language difficulties and markedly reduced bilateral fine motor functioning. In addition, problems with higher order executive skills (i.e., cognitive flexibility, problem-solving, and hypothesis testing) were elucidated, correlating with individual findings on neuroimaging.

Conclusions
Neuropsychological evaluation of Mr. James contributes to the dearth of research surrounding MELAS. These findings also highlight the importance of neuropsychological testing as part of the comprehensive evaluation for diagnostic clarification, and provide recommendations of the functional impact for others affected with this disease.
B-21 Neuropsychological Profiles and Co-morbid Diagnosis of Patients with HIV Seen in an Outpatient Psychology Clinic
Authors: Cassill C , Rosenstein L 
Published: August 2019

Abstract
There is a high rate of medical and psychiatric comorbidities in the HIV population (Kilbourne et al, 2001), many of which complicate the clinical picture, especially with respect to cognitive functioning (Milanini & Valcour, 2017). It is important to be aware of the impact multiple disorders can have on formulating impressions and treatment planning. We reviewed the records of 35 consecutive patients with HIV seen in our neuropsychology clinic in a county hospital. The 30 men and 5 women had a mean age of 49 (SD = 13.7), with mean education of 13.5 years (SD = 2.0). Average age of HIV diagnosis was 33 (SD = 9.3). Patients had an average of eight major comorbid medical and psychiatric diagnoses, including ADHD (45%), mood disorders (62%), developmental disorders (11%), substance abuse or dependence (45%), sleep apnea (11%), TBI (31%), stroke (14%), cardiovascular disease (51%), and hepatitis (20%). Neuropsychological data were available for 33 patients. Performance on CVLT Trial 5 and Delayed Recall, Rey-Ostereith Copy, WAIS-IV Information and Digit Span, as well as Trail Making A and B were used to measure memory and executive functioning. 21% of the sample obtained one score that was >2 SD below the normative means, and 45% obtained 2 or more scores >2 SD below the mean.In this clinical sample referred for evaluation of cognitive functioning, there was a high rate of comorbid diagnoses. This review highlights the point that comorbid diagnoses are a common presentation and must be considered when discussing etiology of cognitive impairment and treatment planning.
B-22 Non-Convulsive Seizure and Post-Ictal Psychosis Presenting as Foreign Language in a Monolingual Patient: A Case Report
Authors: Nabulsi Y , Cahill J , Kotlarz P 
Published: August 2019

Abstract

Objective
This paper seeks to advance the discussion of foreign language automatisms and clinical consequences of Non-Convulsive Status Epilepticus (NCSE) such as post-ictal psychosis. We present the first case of a monolingual English speaker communicating solely in Spanish, a non-native language during an epileptic episode.

Method
A 70-year old man with no history of seizures, epilepsy, or psychiatric illness presented to his primary care provider with episodes of confusion and "speaking Spanish." Prolonged video EEG performed after admission demonstrated a disorganized background with a mixture of generalized theta and delta activity with frequent focal and generalized ictal and epileptiform activity occurring predominantly out of the right hemisphere.

Results
Laboratory evaluation punctures were unrevealing. MRI of the brain with and without contrast were both normal. Keppra and Depakote were continued during the admission. His psychosis and cognitive impairment improved slowly over several days though he did not return back to his neurological baseline. He returned to speaking only English after several days of treatment. He continued to have frontal lobe dysfunction with psychotic features. A diagnosis of rapidly progressive dementia of unclear etiology was given.

Conclusion
Though foreign language automatisms are a rare consequence of NCSE, the combination of psychotic symptoms and confusion presented in this case creates an interesting connection between psychosis, dementia syndromes, and epilepsy, all involving aberrant activity or deficits in similar brain regions. The generation of foreign language automatisms may indicate a form of psychotic symptomology manifesting as a language anomaly as opposed to visual hallucinations, delusions, or formal thought disorder.
B-27 Primary Progressive Multiple Sclerosis in an Older Man
Authors: Schieszler-Ockrassa C , Bylsma F 
Published: August 2019

Abstract

Objective
Multiple sclerosis (MS) is an autoimmune demyelinating disease more common in women than men, usually diagnosed between 20-30 years of age. Approximately 50% of individuals with MS develop cognitive dysfunction, with men and progressive MS subtype cases at higher risk (Beatty & Aupperle, 2002). Mr. Doe’s case is unique because he was diagnosed with primary progressive MS at age 56 and demonstrated only mild cognitive dysfunction.

Method
Mr. Doe presented to his neurologist with complaints of extreme fatigue, slowed processing, and sensory and motor disturbances. He was seen for neuropsychological evaluation one year after diagnosis and was reassessed one year later. He reported worsening mood including passive suicidal ideation since diagnosis. He reported difficulties with work duties (attorney) and household demands due to gradual motor and sensory disturbances, slowed processing speed, fatigue, and mood disturbance.

Results
Mr. Doe’s initial neuropsychological assessment revealed variability in auditory working memory, weakness in sustained visual attention, and mild deficits in upper extremity fine motor dexterity. Memory, executive functioning, language, and processing speed were all intact unless a motor component was involved (mild decline after one year). His cognitive performances remained generally stable after one year, but depression, anxiety, and hopelessness levels were all significantly worse.

Conclusions
Although Mr. Doe’s impairments are extremely mild and somewhat unexpected given the primary progressive MS diagnosis, his gender, and age, the affected domains are consistent with the diagnosis. This case demonstrates the importance of understanding base rates for conditions we assess, but also not ruling out lower base rate conditions.
B-30 Sturge-Weber Syndrome in Adulthood: A Case Study of Superior Cognitive Reserve
Authors: Abramson D , Fredrick A , Bell Z , Fink J 
Published: August 2019

Abstract

Objective
Sturge-Weber Syndrome (SWS) is a neurological disorder usually diagnosed in childhood and characterized by facial port-wine stains, seizures, and intracranial vascular malformations. SWS is associated with a variety of neuropsychological presentations in children, but the adult cognitive profile of this disease is not well established. Specifically, little is known about how cerebral abnormalities found using Magnetic Resonance Imaging (MRI) correlate with cognitive difficulties in adulthood or if certain prognostic factors can predict cognitive outcome.

Methods
The present case involved a 53-year-old, left-handed, Caucasian female with 20 years of education with SWS, possible seizures, multiple concussions, posttraumatic stress disorder (PTSD; multiple reported traumas) and bipolar disorder, referred for a neuropsychological evaluation for progressive problems with memory, word-finding, and coordination over the last 14 years. A neuropsychological evaluation was administered and structural neuroimaging was reviewed.

Results
MRI studies revealed left hemispheric atrophy with enlargement of the left ventricle, cortical calcification in the left temporo-occipital region, cerebrovascular disease particularly in the frontal lobes, and vascular malformations. Despite severe neuroanatomical abnormalities associated with SWS, as well as comorbid psychiatric disorders, a neuropsychological evaluation revealed a relatively intact cognitive profile, with only scattered minor inefficiencies in attention/processing speed, executive functioning, and motor functioning.

Conclusions
This case provided an example of good prognosis of SWS in adulthood, despite significant brain abnormalities, potential seizure activity, multiple concussions, and psychiatric comorbidity. Further research is needed to conceptualize the neuropsychological impact of SWS in adulthood, specifically whether aspects of superior cognitive reserve (e.g., higher education) are associated with better prognosis.
B-34 Correspondence of Latent Neurophysiological and Neurocognitive Profiles to Psychosis Biotypes
Authors: Rhoads T , Gotra M , Kaseda E , Hill S 
Published: August 2019

Abstract

Objective
The Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) Consortium has developed a novel classification system for psychotic-spectrum disorders that emphasizes objective and neurobiologically valid measures. However, these ‘biotypes’ were created based on a lengthy battery of tests including electroencephalography (EEG), which is time-consuming to administer and not widely available in most clinical settings. The aim of the present study was to evaluate the degree to which classifications obtained using only cognitive and eye tracking paradigms correspond with the biotypes, which would allow for a more efficient approach to diagnosis of psychotic-spectrum disorders that could feasibly be implemented in a clinical setting.

Method
This study utilized latent profile analysis to identify distinct profiles in 683 patients diagnosed with schizophrenia, schizoaffective, or bipolar with psychosis and compared the solution to previously assigned biotypes.

Results
A 3-profile solution provided the best fit for the data (p = .02) and the profiles were characterized by varying degrees of cognitive and sensorimotor impairment. The most impaired profile accurately classified 58.1% of the probands in the most impaired biotype; the least impaired profile classified 63.4% of the least impaired biotype. The intermediate profile did not discriminate between biotypes.

Conclusions
Using composite scores to represent general cognition, eye tracking, and inhibitory control led to better classification of individuals at neurocognitive extremes, but not intermediate levels. These results suggest that the EEG findings are essential to better classify psychosis probands with intermediate impairment and contribute unique variance that may be clinically significant in classifying a subset of psychotic patients in treatment settings.
B-36 Effects of Electroconvulsive Therapy on Cognitive Performance and Depressive Symptoms: A Naturalistic Study
Authors: Goegan S , Hasey G , Ballantyne E , MacKillop E , King J , Gojmerac C , Losier B , Bieling P , McKinnon M , McNeely H 
Published: August 2019

Abstract

Objective
1) Examine the short- and long-term effects of electroconvulsive therapy (ECT)—conducted in a naturalistic treatment setting—on objective and subjective cognitive functioning. 2) Examine the long-term effects of naturalistic ECT on depressive symptoms.

Method
Participants (N = 108) were outpatients (aged 18-65) diagnosed with a Major Depressive Episode who received ECT at St. Joseph’s Healthcare Hamilton, Ontario. Parameters of ECT varied clinically. Participants completed a cognitive and psychological test battery at baseline (n = 108), mid-treatment (n = 82), 2–6-weeks post-ECT (n = 52), 6-months post-ECT (n = 24), and 12-months post-ECT (n = 14) that included Repeatable Battery for Assessment of Neuropsychological Status (RBANS), Squire Subjective Memory Questionnaire (SSMQ), Beck Depression Inventory-II (BDI-II), and WHO Disability Assessment Schedule (WHODAS-2).

Results
Overall cognitive performance (total RBANS scaled scores) did not improve from baseline to 2-6 weeks post-ECT (p = 0.156), significantly improved from baseline to 6-months post-ECT (t(22) = -2.34, p = .026, CI: = -8.93– -0.63), but were not maintained at 12-months post-ECT (p = 0.20). SSMQ scores significantly worsened from baseline to mid-ECT (t(75) = -5.04, p < .001, CI: -17.53– -7.60), but returned to baseline levels by 2–6-weeks post-ECT. Depressive symptoms (BDI-II) significantly improved by the 4th ECT session and gains were maintained across all timepoints (p < 0.004). WHODAS-2 scores significantly improved from baseline and were maintained across follow-up (t < 0.05).

Conclusion
ECT was effective at improving depressive symptoms in a naturalistic setting with diverse patient presentations. Preliminary findings show minimal, if any, gains in cognitive performance–although, functioning did not appear to worsen following ECT. RBANS may not be sufficiently sensitive. Developing recommendations for conducting and evaluating ECT in naturalistic settings marks an essential next step.