bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 23 Duration of COVID-19 Predicts Reports of Cognitive Symptoms
Authors: Burton Jonathan , Field Tiffany , Levin Leanne 
Published: September 2024

Abstract

Objective
Most individuals recover from COVID-19 within a few weeks; however, some develop chronic symptoms. COVID-19 can affect the brain, and some patients report cognitive issues. Symptom chronicity may be associated with a greater rate of cognitive complaints. This study examined the relationship between COVID-19 symptom duration and reported cognitive problems.

Method
An archival database was used for this study’s data analyses. United States residents were recruited through Qualtrics and surveyed on their COVID-19 experiences (N = 1918). 173 participants (42% female, 82% Caucasian/White) who reported active COVID-19 symptoms when completing the survey were included in the data analyses. Participants answered how long they had experienced COVID-19 symptoms (ordinal variable with seven levels) and a checklist of the symptoms they experienced, including five cognitive symptoms. Items were “Brain/mind fog,” “Difficulty Concentrating,” “Forgetfulness,” “Word finding problems,” and “Confusion.”

Results
Five logistic regressions were conducted with symptom duration as the predictor variable and reported cognitive symptoms as the dependent variables. COVID-19 symptom duration significantly predicted all self-reported cognitive issues. Symptom duration most strongly predicted forgetfulness, B = 0.39, SE = 0.11, Wald = 13.71, p &lt; 0.001. The probability of reporting forgetfulness increased by 47% (Exp(B) = 1.47, 95%CI[1.20, 1.81]) per unit increase in symptom duration.

Conclusions
These results suggest that a longer duration of COVID-19 symptoms predicts cognitive complaints. As this is a cross-sectional database, directionality cannot be determined. Cognitive effects could derive from chronic illness or to other physiological and psychological changes in chronic COVID. Both possibilities imply that healthcare providers should consider cognitive symptoms when evaluating complaints of chronic COVID-19 patients.
A - 29 Support for Use of Cognitive Rehabilitation Strategies to Enhance Accessibility of Medications for Opioid Use Disorder Treatment: a Qualitative Secondary Data Analysis
Authors: Hernandez-Vallant Alexandra , Cruz-Dixon de Naila V , Hurlocker Margo C 
Published: September 2024

Abstract

Objective
Despite cognitive rehabilitation paradigms gaining support as adjunctive interventions to opioid use disorder treatments, limited research details strategies that medical providers who prescribe medications for opioid use disorder (MOUD) employ to attend to patient cognitive limitations. We conducted a secondary data analysis to explore this gap in the literature.

Method
The parent study included individual interviews with 23 MOUD treatment providers from New Mexico and Washington state, and the interview guide centered barriers and facilitators to equitable implementation. A deductive thematic analysis was utilized to identify sources, solutions, and strategies that MOUD providers identified for patients experiencing cognitive impairments.

Results
Regarding sources of cognitive dysfunction, history of stroke, overdose, severe mental illness, and traumatic brain injury were emphasized. Low health literacy was also identified as a justification to modify approach. Strategies providers utilized fell under five subthemes: visual aids; communication (e.g., repetition; open questions); engaging caregivers; leveraging peer support; and increasing visit frequency. Though less common, some providers emphasized only focusing on substance use and safety.

Conclusions
There have been calls to better attend to cognitive functioning as a potential moderator of MOUD treatment outcomes; however, existing personalized care guidelines do not address this adequately. The present study revealed variability in clinical decision-making that may exacerbate health inequities among individuals seeking MOUD treatment –a population disproportionately impacted by social determinants of health (e.g., housing; access to healthcare; quality of education). Greater focus on equitable MOUD implementation is needed to explore methods of personalizing care for individuals seeking MOUD treatment presenting with cognitive dysfunction.
A - 32 The Patient Global Impression of Change—a Powerful Complimentary Tool for Assessing Improvement in Concussion Patients
Authors: Hungerford Lars , Remigio-Baker Rosemay , Bailie Jason , Ivins Brian , Lopez Juan , Ettenhofer Mark 
Published: September 2024

Abstract

Objective
The purpose of this study was to determine the extent to which patient’s perspective of symptom improvement, as indexed by the Patient Global Impression of Change (PGIC) survey, is associated with symptom improvement on common measures of neurobehavioral and mental health symptoms following concussion.

Methods
Data were from 474 US active duty service members in interdisciplinary treatment programs for TBI. PGIC rating (range = 1–7) was evaluated for compatibility in assessing improvement in or clinically-elevated neurobehavioral (using Neurobehavioral Symptom Inventory, NSI) and mental health (using Post-traumatic Stress Disorder Checklist, DSM-5, PCL-5 and Patient Health Questionnaire, PHQ-8) symptoms.

Results
Higher PGIC scores were related to a higher prevalence of a clinically-relevant decrease in NSI, PCL-5 or PHQ-8 scores. Participants with a PGIC rating of 3+ (vs. &lt; 3) were about 2.2 (CI = 1.4–3.5), 1.6 (CI = 1.1–1.3), and 2.7 (CI = 1.4–5.1) times more likely to report a clinically-relevant decrease in NSI, PCL-5 and PHQ-8 symptoms, respectively.

Conclusion
PGIC may help providers incorporate patients’ perspectives on symptom improvement achieved during rehabilitation. An approach combining PGIC with surveys such as NSI, PCL-5 and PHQ-8 may provide a more comprehensive understanding of symptom improvement and realistic view of expectations for what would be deemed recovery to pre-injury symptom levels.
A - 36 Cognitive Impairments Linked to ADHD Severity and Insurance Gaps among U.S. Children
Authors: Nenni Jordan , Stuart Elizabeth M 
Published: September 2024

Abstract

Objective
To evaluate the presence and severity of attention-deficit/hyperactivity disorder (ADHD) in children in the United States, and to explore the relationship between ADHD, functional cognitive impairments, access to evidence-based treatments, and adequate health insurance.

Method
This study included children aged six to 17 (n = 34,109) from the 2022 National Survey of Children’s Health (NSCH) representing diverse races, ethnicities, and socioeconomic statuses. Data was collected on ADHD diagnosis, severity, insurance coverage, medication/behavioral treatment, and cognitive impacts.

Results
Of the participants, 10.5% reported ADHD, with 4.4% reporting mild symptoms and 6% reporting moderate to severe symptoms. The more severe ADHD symptoms were, the greater impact on cognitive performance was noted χ2(2,N = 4772) = 705 p &lt; 0.001; with mild ADHD rarely impacting cognition resid.(1,2) = −421. Only 13.9% of children with ADHD is currently covered by health insurance, and only 6.6% of children with ADHD have health insurance to cover their mental and/or behavioral health services. Of those insured, children with severe ADHD were more likely to have insufficient coverage χ2(8,N = 4642) = 362 p &lt; 0.001; resid.(3.3) = −23.5.

Conclusions
The study revealed a considerable 10.5% of U.S. children currently have ADHD, with greater cognitive impacts revealed for children with greater severity of symptoms. Results also revealed critical disparities in ADHD management, and in turn their cognitive functioning. While 59.7% reported insurance always covered mental health needs, and 13.9% indicated inconsistent coverage, contributing to treatment gaps. This lack of coverage particularly affects children with moderate to severe ADHD, exacerbating cognitive impacts. These findings underscore the need for comprehensive ADHD care and improved, consistent mental health coverage.
A - 38 Impact of Working Memory and Processing Speed on Executive Function Performances in Youth with Attention-Deficit/Hyperactivity Disorder and Learning Disorder
Authors: Cichocki Anna , Kirsch Alexandra , Nicholson Laura 
Published: September 2024

Abstract

Objective
Executive function (EF) differences exist among children and adolescents with comorbid attention-deficit/hyperactivity disorder and learning disorders (ADHD+LD), relative to ADHD or LD alone. The impact of cognitive proficiency (i.e., working memory and processing speed) on EF is unclear across these diagnoses.

Method
This study investigated relations between cognitive proficiency and EF measures for 360 clinic-referred youth (ages 8–18) diagnosed with ADHD, LD, ADHD+LD, or No Diagnosis of ADHD/LD following neuropsychological evaluation. Two-way ANOVAs determined if WISC-V or WAIS-IV working memory (WMI) or processing speed (PSI) indices moderate the associations between group and D-KEFS performance (i.e., Color-Word Interference, Tower, Verbal Fluency, and Trail Making Tests).

Results
Results revealed significant interactions between group and WMI or PSI affecting D-KEFS Verbal Fluency Category Switching (F’s = 3.00–3.13, p’s = 0.026–0.031). Better performance on WMI or PSI was associated with better performance on Verbal Fluency Category Switching across groups, but this association was significantly less for ADHD+LD compared to other groups. Positive main effects were observed between WMI or PSI and all D-KEFS measures (F’s = 7.62–84.86, p’s &lt; 0.006). Significant main effects were observed between group and D-KEFS Color-Word Interference Inhibition and Trails Number-Letter Sequencing (F’s = 2.95–3.77, p’s = 0.013–0.035), where No diagnosis performed better than other groups.

Conclusions
Overall, stronger working memory and processing speed may aid EFs for No diagnosis, ADHD, and LD youth, but not ADHD+LD youth. This may suggest an additive impact of a comorbid diagnosis leading to worse deficits in EFs and that stronger working memory and processing speed may be less protective for youth with comorbid diagnoses. Additional research is warranted.
A - 39 The Physical and Neurological Examination of Subtle Signs (PANESS) as a Predictor of ADHD
Authors: Eisenstat Lauren , Kheradbin Nusha , Paulos Stephanie 
Published: September 2024

Abstract

Objective
The Physical and Neurological Examination of Subtle Signs (PANESS) is a pediatric neuromotor exam. Prior research shows children with attention deficit hyperactivity disorder (ADHD) may exhibit neurological soft signs. This study investigates the predictability of PANESS performance on other ADHD measures.

Methods
Subjects included 52 children aged 8–16 seen clinically for evaluation at Austin Neuropsychology. Dependent variables included Digit Span (DS), Test of Everyday Attention (TeaCh), Conners Continuous Performance Test (CCPT-3), and Delis-Kaplan Executive Function System (DKEFS). The raw scores of PANESS tasks were the independent variables.

Results
DS was significantly predicted by the foot tap (FT) (p = 0.017), foot heel-toe tap (FH) (p = 0.028), hand pat (HP) (p = 0.018), finger tap (FinT) (p &lt; 0.001), and appose finger succession (AFS) (p = 0.012) tasks on the PANESS. The Category Fluency (CF) subtest on DKEFS Verbal Fluency was also significantly predicted by the FT (p = 0.043), FH (p &lt; 0.001), hand pronate/supinate (HPS) (p = 0.003), FinT (p = 0.003), FA (p &lt; 0.001) tasks. All PANESS tasks significantly predicted performance on Trial 2 of DKEFS Color-Word (FT: p = 0.012; FH: p = 0.015; HP: p = 0.002; HPS: p = 0.009; FinT: p = 0.003; FA: p = 0.002). The FA task was a significant predictor of all trials of CWI (T1: p &lt; 0.001; T2: p = 0.002; T3: p &lt; 0.001; T4: p &lt; 0.001).

Conclusion
The PANESS predicts performance on some ADHD tasks, though not others. This finding prompts further investigation into how PANESS can be integrated into clinical settings to enhance ADHD diagnosis and understanding.
A - 42 Exploring Emotional Regulation Difficulties and Achievement-Oriented Parental Psychological Control as the Moderators of the Association between Academic Enablers and Academic Skills in Hispanic Adolescents
Authors: Chen Shiyuan , Demaray Michelle 
Published: September 2024

Abstract

Objective
This study explored how emotional regulation difficulties and parental psychological control (achievement-oriented) moderate the association between academic enablers (motivation, engagement, study skills, interpersonal skills) and academic skills (reading, writing, mathematics, critical thinking).

Method
Responses from 157 adolescents (average age = 12, 63% Hispanic, 46% female) using the Academic Competence Evaluation Scales, the Difficulties in Emotional Regulation Scale, and the Achievement-Oriented Psychological Control measure were analyzed using the PROCESS macro conditional analysis model 3 in R (Hayes, 2013).

Results
Results indicated that emotional regulation moderated the association between academic enablers and academic skills and that this moderation was further moderated by psychological control, F(7, 149) = 63.5, p &lt; 0.00. Specifically, the academic enablers-skills association was stronger for adolescents experiencing higher emotional regulation difficulties and psychological control, Tb7 = 0.0046. Probing the interaction using a modified pick-a-point approach revealed that the conditional effect of the interaction between academic enablers and emotional regulation difficulties on academic skills was significant at the 84th percentile of psychological control, θXW → Y|(Z = 3.11) = 0.0076, p = 0.0075. Alternatively, probing the interaction using the Johnson-Neyman technique revealed that the conditional effect of the interaction between academic enablers and emotional regulation difficulties on academic skills was significant when parental psychological control was greater than or equal to 2.49.

Conclusions
The study highlights the importance of academic enablers in skill development, especially for adolescents who experience moderate to high emotional regulation difficulties and parental pressure to succeed. Targeted interventions to improve adolescents’ emotional regulation capabilities and lessen controlling parent–child dynamics could be crucial.
A - 44 Value of Repeat Neuropsychological Assessments in Children with Complex Birth and Neurological Injuries
Authors: Alexander Anaiya K , Culotta Stephanie O 
Published: September 2024

Abstract

Objective
Extremely low birth weight, in-utero insult, and PVL are associated with an array of neurodevelopmental complications. PVL is most common in very premature. Associated complications in this case study include diffuse demyelination, cerebellar atrophy, and arthrogryposis. Data from serial assessments reveal preservation of intelligence, decoding, and social skills. Implications for the role of repeat assessments in guiding education and intervention are discussed.

Method
The subject was an 18-year-old male with extremely low birth weight, in-utero insult, PVL, cerebellar atrophy, delayed myelination, and arthrogryposis. His presentation also included craniosynostosis. Three outpatient neuropsychological assessments were completed over eight years. Assessments included measures of intellectual, academic, neurocognitive, and emotional functions.

Results
Despite multiple physical and neurological impairments, assessments revealed preserved verbal and nonverbal intelligence, phonemic awareness, computation skills, and social cognition. Deficits were evident in processing speed, rapid naming, math fluency, word fluency, working memory, and executive functions. Academic strengths were evident in reading and written expression. Checklists revealed inattention and impulsivity with strengths in social cognition (See data tables).

Conclusions
This study demonstrates both variability in outcome following a complex birth history and neurological history and the value of repeat neuropsychological assessments. Assessment data was used to identify and build upon preserved skills and focus intervention strategies. Maintained verbal and nonverbal reasoning skills, in the context of strong social cognition, significantly contributed to progress, self-esteem, and future goals. Repeat neuropsychological assessment is well-suited for such cases. Access to such assessments is critical and should be regarded as medically necessary to guide intervention and promote positive outcomes.
A - 46 Relationship between Working Memory and Externalizing Behaviors in Children from a Clinical Population: an Exploration of the Role of Expressive Language
Authors: Zheng Le , Holmquist-Day Lori , Hakman Melissa , Shao Yi , Shepherd MaryAnn 
Published: September 2024

Abstract

Objective
Externalizing behaviors affect children’s functioning in different domains. Previous studies revealed the impact of working memory, mainly through its role in goal keeping, goal-related search, and response selection. This study explored the role of expressive language in the relationship between working memory and externalizing behaviors in children.

Method
The data were collected from 50 children at a private practice agency (male: 76%; Age M = 4.16, SD = 1.13). All participants were diagnosed with at least one neurodevelopmental disorder. Their index score on the Externalizing Problems from Behavior Assessment System for Children, 3rd Edition, index score on the Working Memory from Stanford-Binet Intelligence Scales, 5th Edition, and expressive language subscale score from Vineland Adaptive Behavior Scales, 3rd Edition were collected. A mediation analysis was performed.

Results
The mediation analysis results showed a significant indirect effect (B = −0.081, 95% CI [−0.172, −0.015]) of working memory on externalizing behaviors through expressive language. It suggested that poorer working memory was associated with less expressive language, which then resulted in more externalizing behaviors. The direct effect between working memory and externalizing behavior was statistically significant (B = −0.331, p &lt; 0.001), indicating that expressive language only partially mediated the relationship between working memory and externalizing behaviors.

Conclusions
The study provided empirical support for the mediating effect of expresive langaguge on the relationship between working memory and externaizing behaviors in children from a clinical population. It informs that the use of evidence-based interventions on expressive langauge skills might potentially help address externalizing behaviors in children.
A - 49 The Role of the Tuberous Sclerosis Associated Neuropsychiatric Disorders Checklist in Pediatric Neuropsychological Assessment: a Case Study
Authors: Tamura Kabrianna , Weiss Erica , Bronsteyn Diana , McGinley John , Stimmel Marnina , Facchini Ronda 
Published: September 2024

Abstract

Objective
The Tuberous Sclerosis Associated Neuropsychiatric Disorders (TAND) checklist is a screening tool developed to assist in clarifying behavioral, psychiatric, neuropsychological, and psychosocial manifestations experienced by individuals with Tuberous Sclerosis Complex (TSC). TSC is a multisystem disorder, impacting 1 in 6000 children annually, caused by mutations in the TSC1/TSC2 genes that results in tumor growth throughout the body associated with widespread adverse medical and neurological outcomes including cognition. We present the use of the TAND checklist in a child referred for cognitive evaluation in the context of TSC to explore its potential use within neuropsychological assessment.

Method
Eleven-year-old female with TSC, referred by neurology, was seen for outpatient neuropsychological evaluation. Comprehensive neuropsychological testing and completion of the TAND checklist with parent were completed.

Results
Evaluation revealed variable cognitive performances with strengths in fluid reasoning and relative weakness in working memory. Academic performances were low average with weakness in reading. Overall slowed and disrupted processing impacted performance across domains. TAND checklist helped elucidate parental report about cognitive and psychological difficulties.

Conclusions
This eleven-year-old girl’s profile was variable across domains, consistent with research findings that TSC is a multisystemic disorder presenting in widespread dysfunction. Implementing the TAND checklist was helpful in efficiently eliciting symptomology across domains from parent collateral informant, demonstrating its augmentative value to comprehensive neuropsychological assessment in children with TSC. This is an important next step in validating the TAND checklist in neuropsychological settings.
A - 52 The Impacts of Prior Exposure to Outdoor Air Pollution on Cognitive Ability during Adolescence: a Systematic Review
Authors: Carter Emily , Cook Nathan 
Published: September 2024

Abstract

Objective
The aim of this study was to examine the effect of prior exposure to outdoor air pollution on adolescent cognition. 36% of Americans live in counties with unhealthy air quality; this been tied to an increased risk of developing chronic conditions. Adolescent brains are still under development, potentially making them more susceptible to the negative effects of air pollution. It is important to understand whether exposure during this critical developmental period leads to cognitive disturbances later in life.

Data Selection
A total of 356 abstracts from PubMed were screened, based on the inclusion criteria: reported original data, published in English, conducted on human subjects, published in 2014–2024, assessed outdoor air pollution, outcome measure assessed cognition, and the outcome assessment was measured at Mage of 12–18. 12 studies met the inclusion criteria; the following data was extracted into a spreadsheet: sample size, mean age of participants, participant demographics, how the predictor and outcome variables were measured, and relationship between the predictor and outcome variables.

Data Synthesis
Out of the 12 studies, 6 cognitive domains were assessed. 8 studies found increased levels of air pollution was associated with worse cognitive outcomes, while 4 studies found no association.

Conclusions
Results suggest a possible link between outdoor air pollution and cognitive ability, although further research should be conducted. Currently, there is an age gap in the literature as this domain continues to be focused on infants and older-adults, but a limited amount is being conducted on adolescents. The importance of the developing adolescent brain must not be overlooked.