The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is one of the most widely used measures in neuropsychological assessment. Studies of practice effects on the RBANS have largely been limited to studies assessing one or two repeated assessments. The aim of the current study is to examine practice effects across four years after baseline in a longitudinal study of cognitively healthy older adults. Practice effects were estimated using a pseudo-replacement participants approach which has been previously applied in other aging studies.

453 Participants from the Louisiana Aging Brain Study (LABrainS) completed the RBANS Form A on up to four annual assessments after a baseline evaluation. Practice effects were calculated using a modified participants-replacement method where scores of individuals who were administered RBANS Form A multiple times are compared to the baseline scores of matched participants with additional adjustment for attrition effects.

Practice effects were observed primarily in the immediate memory, delayed memory, and total score indices. For example, an increase of nearly half a standard deviation was observed for delayed memory.

These findings extend past work on the RBANS and other neuropsychological batteries more broadly in showing the susceptibility of memory measures to practice effects. Given that memory and total score indices of the RBANS have the most robust relationships with diagnostic status and biomarkers for pathological cognitive decline, these findings raise concerns about the ability to recruit those at risk for decline from longitudinal studies using the same form of the RBANS for multiple years.

Code-switching is when bilingual individuals alternate between two languages in the same conversation. Some studies find that code-switching frequency is associated with executive functioning, while others do not. Individual attitudes towards bilingual language use and code-switching may explain the inconsistency in the literature. For instance, greater positive attitudes towards code-switching may be associated with more likelihood to engage in that practice and thus strengthen the cognitive benefit in executive function. Additionally, code-switching between English and Spanish has been stigmatized in the U.S., therefore it is unclear what sociocultural factors may predict positive attitudes. In this study, we assessed Latinx bilinguals’ attitudes on code-switching and investigated their relationship with code-switching frequency, sociodemographic and linguistic factors, and executive functioning.

Participants were 525 community-dwelling English-Spanish bilingual Latinx adults from the Offspring study (Mage= 55.38 (10.42); Meducation= 12.62 (3.34); 71% women; 41% tested in English, 75% immigrant). A language history questionnaire assessed for bilingualism and code-switching frequency. Participants completed 7 questions on code-switching attitudes on a 7-point Likert scale ranging from Strongly Disagree to Strongly Agree (e.g., “switching between languages in a conversation is an important part of my identity”), that were summed for a total score with higher scores indicating more positive attitudes. Executive functioning was assessed with the NIH Toolbox Cognition battery, verbal fluencies, and the digit span test. Sociodemographic and linguistic factors included age, sex, education, immigrant status, parental years of education, English and Spanish proficiency (average score on self-reported ratings on speaking, reading, writing, and understanding), and testing language. General linear models evaluated the association of code-switching attitudes on executive function, after adjusting for relevant covariates.

Positive code-switching attitudes were correlated with greater code-switching, r(499)=.33, p<.001. Younger age r(499)=-.11, being born in the US t(493)=-2.05, greater English proficiency r(497)=.15, and English dominance t(499)=2.22, were associated with more positive code-switching attitudes (all p’s <.05). Sex, education, parental years of education, and Spanish proficiency were not associated with code-switching attitudes. Overall models of attitudes with executive function indicated that positive code-switching attitudes were associated with worse visual working memory (b = -0.08, t(169) = -2.75, 95% CI [0.14, -0.02]) after adjusting for age, sex, education, immigration status, parental years of education and testing language. Code-switching attitudes were not significantly associated with other executive function measures.

Among a community-based sample of bilingual middle-aged Latinx adults, positive attitudes towards code-switching were associated with greater likelihood of code-switching in conversations, higher English proficiency, being US born, younger age, and English language dominance but negatively associated with visual working memory. These findings indicate that code-switching attitudes are influenced by sociodemographic and linguistic factors. Additionally, the negative association between code-switching attitudes and visual working memory provides support for previous studies showing code-switching as a disadvantage to cognition. Results of this study suggest that detailed characterization of sociocultural factors and aspects of bilingualism can provide further clarity in determining if there is a potential bilingual cognitive advantage. Future research should examine the relationship of code-switching with other aspects of bilingualism (e.g., age of acquisition).

Semantic verbal fluency (SVF) has traditionally been correlated with activity in the left anterior temporal lobe. Damage to the anterior temporal lobe, such as from a traumatic brain injury (TBI) or neurodegenerative disease, can result in impairments in semantic fluency and language expression. Although the orbitofrontal cortex (OFC) is not well studied as being correlated to this process, its functional connectivity to language-related brain regions, such as the inferior frontal gyrus (Broca’s area), suggests it may also play a role in SVF. In fact, preliminary research has shown that lesions in the OFC are associated with semantic fluency deficits (Almairac et al. 2015). As such, the goal of this study was to investigate whether OFC volume correlates with SVF in a population of Veterans with a prior TBI.

Thirty-five Veterans who sustained TBIs were included in this study (11% female, age M = 41.77, SD = 11.27; years of education M =14.94, SD = 1.62). All participants underwent a magnetic resonance imaging (MRI) and regional normative volumes were standardized to account for differences in brain size (volume of brain area/total brain volume). Participants were given the Delis Kaplan Executive Function System (D-KEFS) verbal fluency subtest to measure verbal generativity. A Pearson correlation was conducted to investigate the relationship between OFC volume and SVF performance. Post hoc analysis was conducted with Veterans who met the criteria for a TBI sustained by a blast to the head (n = 25).

A significant positive correlation emerged between left OFC volume and semantic fluency (category subtest; p = .03, r = .35). Additional analyses with Veterans with blast-related TBIs indicated a significant correlation between the volume of the OFC and performance on the category (p = .02, r = .45), and switching (p = .02, r = .43) subtests of the D-KEFS verbal fluency test.

These findings demonstrate a correlation between the volume of the left OFC and SVF performance. Specifically, Veterans with TBIs had decreased volume of the OFC which correlated with deficits on a SVF task. Among Veterans with blast-related TBIs, both category and category switching subtests correlated with OFC volume. Given the functional connectivity between the OFC and language areas of the brain, this study highlights the importance of analyzing associated cortical regions beyond the anterior temporal lobe when studying SVF performance.

To compare performances of matched groups derived from caregiver-reported ethnicity on measures of verbal comprehension and visual-spatial abilities, and to identify factors potentially related to differences.

Participants included 159 English speaking children from 615 years of age who were referred for neuropsychological evaluation at a clinic in the southwestern region of the United States. Participants were matched across four groups based on caregiver-reported ethnicity, including American Indian (n = 41), Hispanic (n= 41), White (n = 41), and Other (i.e., Black, Asian; n = 36) categories. Propensity score matching was used to derive samples, with participants matched on age, caregiver-reported sex assigned at birth, and the full-scale intelligence quotient on the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V).

Using a dependent variable derived from subtracting the WISC-V Verbal Comprehension Index from the Visual-Spatial Index, significant differences across groups were found via a factorial analysis of variance model (p = .02, eta squared = .06). Achieved power was .82. Post-hoc analysis indicated significantly greater differences between verbal comprehension and visual-spatial abilities amongst participants of American Indian (mean difference = -6.61 standard score points) and Hispanic (mean difference = -6.66 standard score points) ethnicity relative to participants of White ethnicity (mean difference = 2.17 standard score points; p < .01). Differences did not relate to participant age or assigned sex.

Greater differences between visual and verbal intellectual abilities were found amongst Hispanic and American Indian participants relative to White participants. Hispanic and American children tended to perform higher on visual spatial rather than verbal tasks, while the pattern was reversed for White children. Findings are congruent with previous research conducted using older versions of the WISC and continue to highlight potential issues related to the external validity of this measure in certain populations. This study contributes to the existing literature by replicating previous findings with the most recent iteration of the WISC in a referred sample. Current results continue to suggest that the WISC-V Verbal Comprehension Index may function more as a measure of English language ability rather than verbal intellectual ability. Given these findings, it is important that weaknesses in verbal comprehension amongst children of Hispanic or American Indian ethnicity be interpreted in this context when identified in clinical and research settings. Discrepancies between ethnic groups may relate broadly to cultural and systemic factors (e.g., differing patient/examiner characteristics, inequalities in access to education/intervention and healthcare, bilingualism/exposure to the English language).

Positive psychological attributes have been associated with better health outcomes and quality of life among people with HIV (PWH). Recently, we identified two latent factors (internal strengths, socioemotional support) among 7 positive psychological attributes through factor analysis (Ham et al., 2022). Depression was inversely associated with both factors. Our current aim was to investigate associations between these latent factors, neurocognition, and daily functioning among PWH.

106 PWH and 90 HIV- participants were included in cross-sectional analyses (Mage = 51.3, 77% men, 60% White). Seven positive psychological questionnaires, a neuropsychological battery covering 7 domains, two daily functioning questionnaires (Patient’s Assessment of Own Functioning (PAOFI); Independent Activities of Daily Living (IADL)), and a depression symptom questionnaire (Center for Epidemiologic Studies Depression Scale) were administered. Internal strengths and socioemotional support composite z-scores were calculated using HIV- participants’ scores as reference. Outcomes included global and domain-specific neurocognitive T-scores (demographically-adjusted), global deficit score (GDS), number of functional impairments (PAOFI), and number of functional declines (IADL). Main effects of HIV status, latent factors, and their interaction were included in linear (neurocognition) and Poisson (daily functioning) regressions. Significant interactions were followed up by simple effects analyses and nonsignificant interactions were removed. Depressive symptoms and demographics associated with daily functioning were included as covariates.

PWH exhibited worse neurocognitive performance (global, executive functioning, processing speed, learning, recall, GDS) and reported greater functional difficulties and depressive symptoms compared to HIV-counterparts (ps < 0.05). For neurocognition, there were socioemotional support x HIV status (B = 2.39, p = 0.04) and internal strengths x HIV status (B = 2.70, p < 0.05) interactions on verbal fluency, accounting for depressive symptoms, such that only PWH had a positive association between socioemotional support and verbal fluency (B = 1.97, p = 0.01). Removing nonsignificant interactions, there was a main effect of socioemotional support on global cognition (B = 1.01, p = 0.04) and psychomotor speed (B = 1.83, p = 0.02), independent of HIV status and depressive symptoms. For daily functioning, there was a socioemotional support x HIV status interaction on IADL declines (B = 0.42, p = 0.02), accounting for depressive symptoms and education, such that only HIV- participants had an inverse relationship between socioemotional support and IADL declines (B = -0.64, p < 0.001). Removing non-significant interactions, there were main effects of internal strengths on PAOFI impairments (B = -0.36, p < 0.001) and IADL declines (B = -0.38, p < 0.001), independent of HIV status and depressive symptoms.

Among PWH, both positive psychological factors were associated with better neurocognition, even after adjusting for depressive symptomatology. Though internal strengths were associated with better daily functioning regardless of HIV status, socioemotional support was not related to daily functioning in PWH. While mechanisms underlying these associations cannot be established cross-sectionally, it is possible that among people with medical illnesses complicated by cognitive disturbance, positive psychological factors relate to improved health-related behaviors (e.g., better disease management). Additionally, better neurocognition, including cognitive reserve, may engender greater resilience and improved ability to marshal social support.

Obstructive sleep apnea (OSA) may be a modifiable risk factor for late-life cognitive impairment. We previously demonstrated that non-Hispanic Black older adults are less likely to be diagnosed with OSA despite having equal or greater health risk for OSA compared to non-Hispanic White older adults, and this disparity in diagnosis was strongest among individuals with lower education. Here, we aimed to determine 1) whether there are racial differences in continuous positive airway pressure (CPAP) treatment, 2) how CPAP treatment may influence OSA-cognition associations, and 3) whether CPAP differentially influences OSA-cognition associations across racial groups.

Cross-sectional data were obtained from 424 socioeconomically diverse community-dwelling adults ages 55-83 (63.4±3.2 years, 41.7% male, 53.5% Black) from the Michigan Cognitive Aging Project. Physician-diagnosed OSA and current CPAP use were self-reported. Global cognition was operationalized as a composite of five factor scores derived from a comprehensive neuropsychological battery. Racial group differences were investigated with chi-square and Fisher’s exact tests with statistical significance set at the .05 level. Associations between OSA and cognition (adjusted for age, gender, race, and years of education) were investigated with linear regressions. Subsequent models isolated effects of uncontrolled OSA by excluding individuals using CPAP. Racial differences in OSA-cognition associations were investigated with race-stratified models.

Fewer Black participants (9.2%) reported diagnosed OSA compared to White participants (12.3%; x2 (1, N=424) =5.314, p=.021, cp=.112). In the whole sample, 47.3% of participants with diagnosed OSA reported CPAP use, and this proportion did not differ across race (x2 [1, N=86] =.048, p=.826). In the whole sample, OSA diagnosis was only associated with cognition when CPAP users were excluded (excluding CPAP users: ß=-.085, SE=.037, p=.024; including CPAP users: ß=-.067, SE=.036, p=.062). In race-stratified models, diagnosed OSA was only associated with cognition among Black participants, and this association was stronger when CPAP users were excluded (excluding CPAP users: ß=-.142, SE=.060, p=.018; including CPAP users: ß=-.126, SE=.058, p=.030). Diagnosed OSA was not associated with cognition among White participants, irrespective of whether CPAP users were included (excluding CPAP users: ß=-.084,SE=.068, p=.215; including CPAP users: ß=-.056, SE=.064, p=.378).

Our findings support CPAP treatment as a potential intervention to mitigate late-life cognitive impairment among those with OSA. Despite being less likely to receive a diagnosis of OSA, Black older adults were equally likely to engage in CPAP treatment as White older adults when diagnosed. The detrimental impact of OSA on cognition may be more salient among Black older adults, which may reflect racial disparities in cardiovascular risk and/or resources that promote cognitive reserve. However, CPAP appears to be an effective treatment to reduce OSA-related cognitive impairment for Black older adults, highlighting the critical importance of diagnosis and treatment in this group. Intervention efforts that abate racial inequalities in access to quality healthcare in order to facilitate acquisition of a formal OSA diagnosis and CPAP treatment may help to reduce preventable cognitive health disparities among older adults.

Epilepsy is one of the most common neurological disorders affecting young people globally. While up to 60% of seizures experienced during childhood will resolve, childhood epilepsy can give rise to long-lasting neuropsychological effects which extend far beyond those attributed to seizure activity. While these effects have been explored extensively using quantitative methodologies, little research has examined the lived experience of epilepsy in childhood. The aim of the present study was to capture adults' retrospective insights into the impact of epilepsy throughout their schooling years.

Participants consisted of Irish adults between 18 and 35 years, who had their first seizure on or before the age of 16 years. Participants were recruited from epilepsy support agencies and social media, and self-referred to the study. A bespoke semi-structured interview protocol was developed in collaboration with a patient expert which explored learning experiences, relations with peers, and participants' understanding and support of epilepsy during childhood. The methodology adopted a fully qualitative approach to reflexive thematic analysis. Therefore, patterns across the data were examined whilst taking into consideration the wider social context in which the data were generated. Latent assumptions that may have underpinned participants' experiences were prioritised and data was interpreted using pre existing theories and/or concepts. Interviews were completed following the original abstract deadline, and data analysed thereafter.

Thirteen adults who experienced epilepsy during childhood in Ireland were interviewed. Three primary themes and 14 subthemes were generated from the data. The primary themes were that of (1) disenfranchised grief, (2) the need to belong and (3) meeting the child where they're at. Adults reflected that, as children, the diagnosis of epilepsy evoked feelings typically associated with bereavement or loss. Although adults described childhood epilepsy as isolating, these feelings were countered by the support of friends, family and others with epilepsy, as participants recalled finding their tribe. Participants also called for developmentally appropriate practice when dealing with children and their families, across clinical and educational settings, in order to facilitate more comprehensive understandings of epilepsy and its consequences.

Retrospective qualitative research offers a unique opportunity to explore changes in perception those with childhood epilepsy over time. The present study highlights the need for developmentally appropriate practice, which takes the child's neuropsychological and developmental standing into consideration, when supporting for young people with epilepsy. Given the dearth of research in this field, further retrospective research is needed to fully comprehend the impact of epilepsy in childhood globally.

Research has shown that a small, yet significant minority of individuals with traumatic brain injuries (TBI) experience psychotic symptoms post-TBI. TBI has also been associated with earlier onset schizophrenia in individuals with a genetic risk for psychosis.

The current case presents a 15-year-old female with pre-existing psychotic symptoms (auditory and visual hallucinations [AVH] and delusions) who stopped experiencing AVH a few weeks post-injury. The, at least temporary, cessation of her hallucinations raises several important questions about the neuroanatomy of pediatric psychosis and the impact of TBI on a potentially divergently developing brain.

Patient is a 15-year-old female who identifies as Hispanic (adopted, of Central American origin). Prior to her injury her developmental history was notable probable neglect prior to adoption, and her psychiatric history was notable for major depressive disorder, anxiety, chronic insomnia, and AVH. AVH were religious in nature and involved command hallucinations. AVH had been attributed to her chronic insomnia, per medical records. Participant was in a motorcycle accident with her caregiver and sustained a severe traumatic brain injury (GCS=3-8). Medical workup, including MRI, indicated a right basal ganglia hemorrhage, right thalamic hemorrhage, as well as injury of the brain stem at the pons, resulting in left-sided hemiparesis. She was ultimately diagnosed with traumatic right-sided intracerebral hemorrhage, traumatic subdural hematoma, traumatic hemorrhage of basal ganglia, traumatic encephalopathy, and a left homonymous hemianopia (left visual field cut) from her right temporal parietal injury. She received a neuropsychological evaluation 10 months post-TBI. Testing included: subtests of the WISC-V, measures of sustained attention and executive functioning, tasks of orientation and memory, and questionnaire measures assessing social-emotional, executive, and adaptive functioning. Parent and adolescent clinical interviews were conducted.

Results indicated appropriate orientation, broadly intact intelligence presumed consistent with premorbid functioning, average sustained attention, and deficits in aspects executive functioning, visual-motor processing speed, and fine motor skills. Although she performed well on objective measures of memory, she reported significant long term social memory loss (e.g., difficulties remembering friends and memories of emotional connectedness) during the clinical interview. Interview and questionnaire measures also indicated continued challenges with depression and anxiety, as well as post-traumatic personality changes, tics, and symptoms of trauma. Patient reported that her hallucinations, both visual and auditory, stopped early in her recovery post-TBI; patient’s premorbid delusions were still present post-TBI.

This case raises questions related to the impact of structural or axonal injury to regions or networks in the brain that may be associated with psychosis. It also adds to a minimal literature examining AVH in pediatric TBI. Using the current literature as a framework we will explore 1) the injury to this patient’s thalamus as it relates to both her emotional memory deficits as well as the interruption of her AVH hallucinations, and 2) the relationship between her visual field cut and the interruption of her visual hallucinations. Overall, this case study highlights the unique nature of the developing brain both in terms of the TBI and psychosis.

Many children and adolescents do not achieve adequate sleep durations. The prevalence of sleep problems has been estimated at 7% for typically developing children (Corkum, Tannock, & Moldofsky, 1998) and as high as 45% for representative samples of children, including participants with various diagnoses in proportion to what would be expected in the population (Sher-Fen Gau, 2006). For children with ADHD, the prevalence of sleep problems has been estimated at between 25-50% (Corkum, Tannock, & Moldofsky, 1998). Given the important role that sleep plays in children with ADHD, a brief and effective screener is needed to aid clinicians in assessing for sleep problems, especially when the referral for a neuropsychological evaluation concerns ADHD or any other neurodevelopmental disorder for which presenting concerns involve symptoms that overlap with ADHD. While the developers of the BEARS have demonstrated its utility as a screening tool, there is currently no independent published research replicating this finding. The current study aimed to replicate the findings of the BEARS developers by demonstrating its utility as a sensitive screening tool for sleep problems. It was predicted that the BEARS would demonstrate high sensitivity in identifying children with sleep problems.

Data from 54 school aged children (aged 6-147-13, Mage = 9.83) was analysed. Children were administered the BEARS, and caregivers completed the BEARS and Children's Sleep Habits Questionnaire (CSHQ), as part of a larger study.

Binomial logistic regression model was statistically significant, x2(2) = 20.508, p < .0005. The model explained 46.8% (Nagelkerke R2) of the variance and correctly classified 70.8% of cases. Sensitivity was 78.6%, specificity was 60.0%, positive predictive value was 73.3%, and negative predictive value was 66.7%. Both predictor variables, parent reported BEARS (p = .001) and child-reported BEARS (p = .049), were significant. Children with higher BEARS parent report scores had 3.27 times higher odds, and those with higher self-report scores had 2.88 times higher odds, of exceeding the CSHQ cut-off than those with lower scores. ROC curve analysis revealed that the BEARS parent and self-report scores had excellent diagnostic utility (Hosmer et al., 2013) for accurately classifying children who exceeded the cut-off on the CSHQ from those who did not (area under the curve [AUC] = 0.849, SE = 0.054, 95% CI = .742 to .956, p < .001).

The results of the current study indicate that the BEARS has excellent diagnostic utility for accurately classifying sleep problems. Additionally, it is quick to administer making it a practical screening tool for clinicians to include as part of a comprehensive neuropsychological assessment.

Pediatric brain tumor (PBT) survivors are at risk for speech (e.g., articulation, prosody, fluency) and language (e.g., vocabulary, grammar, narratives, pragmatics) difficulties (Hodges et al., 2020). It is important to understand what treatment and/or demographic factors are associated with language functioning soon after diagnosis, and what factors are associated with language functioning years after treatment completion. This study characterizes longitudinal language functioning for clinically referred PBT survivors diagnosed in early childhood.

Participants were 48 PBT patients (54% supratentorial, 6% disseminated), 21% with NF-1, who were diagnosed by age 6 (M = 43.2 months, SD 24.5) and received tumor-directed intervention including surgery (85%), chemotherapy (69%), and/or radiation therapy (50%). Hearing concerns existed for 29% of the patients. Age at first neuropsychological evaluation was 2-15 years (M=7.6, SD=3.63), age at second neuropsychological evaluation was 5-19 years (M=12.04, SD=3.86), with an average of 4.42 years (SD=2.37) between evaluations. Patients were 63% male, 77% White, 94% non-Hispanic, and fluent English speakers. Verbal IQ, working memory, fluencies, comprehension, memory, and parent-reported functional communication outcomes were assessed as part of comprehensive batteries. Rates of weak performance (1 SD<Mean) were compared to the expected base rate of 16%.

Group means significantly diverged from age-expected performance by the second evaluation in all domains except semantic fluency. Weakness was identified on at least 1 verbal subtest for 79% of the sample at the first evaluation, and for 85% of the sample at the second evaluation. As a group, patients showed a significant increase in the number of weaknesses identified on performance-based measures from the first to second evaluation [t(47) = -3.60, p <.001]. Over half of the sample showed an increase in the rate of verbal weaknesses identified (56.3%). Those with more weaknesses over time had lower IQ at the initial evaluation [t(36) =-2.61, p=.013]. An increase in the number of weaknesses from first to second evaluation was not associated with tumor type/location, treatment modality, or demographic variables.

Brain tumor diagnosis in early childhood during rapid language development is associated with language impairments soon after diagnosis, and years after treatment completion. Causes for continued and increased impairment are multifactorial and risk cannot clearly be identified by demographic and treatment variables alone. Any early language weakness identification should signal need for intervention as the causes for difficulty are complex and these weaknesses are likely to persist and increase over time.

Published results focusing on language assessment in acutely recovered COVID-19 patients have shown communication problems in this group, including significant cognitive-linguistic disruptions in verbal fluency (Cummings, 2022). Extant research also indicates that poorer health-related outcomes, such as reduced physical functioning and quality of life, co-occur with cognitive difficulties post-COVID-19 infection (Mendez et al., 2021; Tabacof et al., 2022). Understanding what factors may worsen the impact of COVID-19 on cognition, and aspects of language function specifically, is necessary to determine who is at greatest risk of adverse outcomes following infection. Our goal was to examine the effect of health-related outcomes on language abilities, specifically verbal fluency, post-COVID-19 infection.

37 adults 19 years and older (M age = 38.78, 67.5% female, 92.5%> high school education) were recruited from British Columbia and Ontario, Canada. Participants provided documentation indicating they had had a COVID-19 infection at least 3 months prior to participation. Participants completed a series of online questionnaires, including the Short Form Health Survey (SF-20), to measure aspects of health-related quality of life. The SF-20 measures dimensions of functioning (physical, social, role) and well-being (mental health, health perception, pain). For each parameter except pain, higher scores indicate better functioning/well-being; for pain higher scores indicate greater pain levels. Participants also completed neuropsychological tests, including measures of verbal fluency, via teleconference. Animals and F-A-S total scores were combined to represent verbal fluency (semantic and phonemic, respectively) performance. To assess the impact of health outcomes on verbal fluency performance, hierarchical regression analyses were conducted. The six SF-20 subscale scores were entered as predictors and verbal fluency score (sum) as the outcome. Age and sex (Male/Female) were controlled for in the model.

Age and sex were not significantly related to verbal fluency scores in our sample. After controlling for these demographics, the overall model including SF-20 subscales did not significantly predict fluency performance (F (8, 28) = 1.04, p = .433). However, Pain scores did individually predict verbal fluency performance (B = 5.60, t = 2.53, p = <.05). Unexpectedly, pain ratings were positively associated with fluency scores, such that each increase in pain rating (e.g., “none” to “mild”) was associated with a fluency score increase of 5.60 points (i.e., 5.6 more words stated across administered tasks).

These preliminary findings suggest that participants’ self-reported pain severity was positively associated with verbal fluency task performance in our sample (i.e., greater pain severity predicting better fluency). These findings are contrary to substantial evidence showing the deleterious effects of pain on cognitive functions in other populations (Khera & Rangasamy, 2021). It is possible that findings may be explained by a potential unknown intervening variable not included in our model. This is the first study to our knowledge to examine associations between experienced pain and verbal fluency performance post-COVID-19 infection. It will be important for future work to not only utilize more robust measures of pain experiences and explore more areas of cognition and language, but also to employ larger samples and examine a broader set of covariates.

There has been a surge in individuals seeking neuropsychological assessment for attention-deficit/hyperactivity disorder (ADHD) after watching social media created by people claiming to have ADHD. While online content may promote destigmatization of ADHD, self-diagnoses derived from social media use may contribute to the development of inaccurate illness beliefs. Individuals who feel strongly connected to social media that mentions personal anecdotes of ADHD might be more likely to believe they also have ADHD. We examined associations between social media search for ADHD and beliefs about everyday experiences being diagnostic of ADHD among adults concerned about having ADHD, as compared to a control group.

A cross-sectional online study included 320 university students (Mage=19.56±2.92; 72% female; 81% White) without history of ADHD. Participants who reported concern about having ADHD, with (n=43) or without other psychological history (n=73) rated whether 100 experiences taken from social media were diagnostic of ADHD, and then rated the amount of time they spent on social media searching for ADHD content. They then rated how often they personally experienced the symptoms. Participants who reported no concern about having ADHD (n=184) only rated how often they personally experienced the symptoms.

Social media search for ADHD was related to total number of experiences believed to be diagnostic of ADHD among participants concerned about having ADHD without psychological history (r=.28, p=.03), but not for those with psychological history (r=.09, p=.57). For participants concerned about having ADHD (regardless of psychological history), social media search for ADHD was related to total number of symptoms personally experienced (rs=.48-.56, ps<.001) and to the number of symptoms endorsed at a clinical level (rs=.48, ps<.001). Total number of experiences believed to be diagnostic of ADHD was related to the number of symptoms personally experienced among participants concerned about having ADHD with psychological history (r=.53, p<.001; clinical level .47, p=.002), but not for those without psychological history (r=.14, p=.31; clinical level .19, p=.15). Of the 100 symptoms, 56 were believed to be diagnostic of ADHD by at least 50% of participants concerned about having ADHD. Of the 56, 43 were personally experienced at a clinical level by controls. For the 13 remaining symptoms not endorsed at a clinical level by controls, symptoms believed to be diagnostic of ADHD was related to symptoms personally experienced among participants concerned about having ADHD with psychological history (r=.53, p<.001; clinical level .52, p<.001), but not for those without psychological history (r=.14, p=.30; clinical level .19, p=.15).

Greater social media search for ADHD is related to higher symptom report among individuals concerned about having ADHD regardless of psychological history. However, individuals concerned about having ADHD without psychological history who engage in greater social media use appear to be more likely to believe that general symptoms are specifically due to ADHD. These individuals may be more prone to misattribute symptoms to ADHD. Nearly 77% of symptoms rated as diagnostic of ADHD were frequently experienced by individuals without concern about having ADHD, which demonstrates the high base rate of ADHD-like symptoms in the general population.

Cognitive decline is expected in normative aging (Cabeza et al., 2018; Salthouse, 2019), which can lead to impairments in adaptive functioning (Yam et al., 2014). Several cognitive domains have been associated with adaptive functioning in older adult samples, including processing speed and executive functioning (e.g., Nguyen et al., 2019; Vaughn & Giovanello, 2010). A recent study examining a mixed clinical sample of older adults demonstrated that processing speed was more predictive of functional decline than other cognitive domains, including aspects of executive functioning (Roye et al., 2022). Therefore, this study attempts to build on previous findings by further examining the relationships between processing speed, adaptive functioning, and executive functioning. Specifically, it investigated the extent to which processing speed mediated the associations between executive functioning and adaptive functioning.

Participants (N = 239) were selected from a clinical database of neuropsychological evaluations. Inclusion criteria were age 60+ (M = 74.0, SD = 6.9) and completion of relevant study measures. Participants were majority White (93%) women (53.1%). Three cognitive diagnosis groups were coded: No Diagnosis (N = 82), Mild Neurocognitive Disorder (NCD; N = 78), and Major NCD (N = 79). The Texas Functional Living Scale (TFLS) was used as a performance-based measure of adaptive functioning. Processing speed was measured using the Coding subtest from the Repeatable Battery for the Assessment of Neuropsychological Status. Executive functioning performance was quantified using part B of the Trail Making Test, Controlled Oral Word Association Test, and Similarities and Matrix Reasoning subtests from the WAIS-IV and WASI-II. Mediation models included age and years of education as covariates and indirect effects were assessed with bootstrapped confidence intervals (Hayes, 2020).

Processing speed mediated all measures of executive functioning. The pattern was consistent for all executive functioning measures such that poorer executive functioning was associated with poorer processing speed, which was subsequently associated with poorer adaptive functioning. Direct effects were significant for all models (ps < .03), suggesting that executive functioning maintained unique associations with adaptive functioning. Follow-up analyses indicated no evidence for moderation of the mediation models based on diagnostic group.

These results highlight the importance of processing speed in understanding real-world implications of pathological and non-pathological cognitive aging. Processing speed mediated all relationships between executive functioning and adaptive functioning. There was no evidence for moderation of these effects, supporting generalizability regardless of neurocognitive disorder and etiologic subtype. Further investigation is warranted into the importance of processing speed in explaining associations of other cognitive domains with adaptive functioning.

The influence of prior knowledge on new learning is well established. However, there has been less research dedicated to teasing apart the key components of prior knowledge’s structure that contribute to memory enhancement. In the current study, we focused on event structures, which include various relations, such as associative, causal, and temporal. Given that events possess attributes relevant to numerous cognitive memory processes, we were most interested in exploring how event structures that possess causal relations enhance new memory formation. Specifically, we examined whether events that exhibit causal associative relations provide an additional boost to new learning compared to event structures with non-causal associative relations.

Forty-six undergraduate students took part in the study. Participants’ learning of the content of image pairs that exhibit everyday, real-world events were measured using a cued recall paradigm. The stimuli consisted of 60 image pairs that illustrated two events that were related causally and associatively (i.e., causal pairs); related only associatively (i.e., non-causal pairs); or not related at all (i.e., unrelated pairs). During an encoding phase, image pairs were presented one at a time, and after the presentation of each image pair, participants answered an encoding question that focused on the relationship between the two images. After the encoding phase and a short filler task, participants were shown a cue image (always the first picture from the pair) and were asked to provide a brief written description of the content of the second presented image from each pair. Also, as a manipulation check, we asked subjects to rate each image pair on causal direction and association strength after completion of the cued recall memory task.

We found that, relative to unrelated pairs, events that possess associative relations (i.e., both causal and non-causal items) benefit learning of new information. In addition, causal relations provided an additional boost to new learning. Specifically, cued recall performance is best for causal pairs, followed by non-causal pairs and unrelated pairs. Moreover, causal direction ratings significantly predict overall itemlevel accuracy above and beyond general associative relations that exist in events. We also examined recall accuracy for specific content information within each event (i.e., agent, action, object) and found that causal relations uniquely contribute to recall performance of objects and actions.

Overall, the present study’s findings suggest that prior event knowledge structures possessing causal and non-causal associative relations support new learning, especially compared to image pairs with no relations. Of interest, causality provides an additional boost to new learning above and beyond general associative relations. By focusing on the role of causality in event structures, our findings informed our understanding of how prior knowledge supports new learning. Considering that the effect of prior knowledge on new episodic learning is especially evident in older adults, since they more readily rely on their schematic knowledge, a future direction would entail investigating how causal links influence new memory formation in older adults.

A 30-item confrontation naming test was developed in Argentina for Spanish speakers, The Cordoba Naming Test (CNT). The Boston Naming Test is an established confrontation naming task in the United States. Researchers have used the Boston Naming Test to identify individuals with different clinical pathologies (e.g., Alzheimer’s disease). The current literature on how Spanish speakers across various countries perform on confrontational naming tasks is limited. To our knowledge, one study investigated CNT performance across three Spanish-speaking countries (i.e., Argentina, Mexico, and Guatemala). Investigators found that the Guatemalan group underperformed on the CNT compared to the Argentine and Mexican groups. The purpose of this study was to extend the current literature and investigate CNT performance across five Spanish-speaking countries (i.e., Argentina, Mexico, Guatemala, Colombia, United States). We predicted that the Argentine group would outperform the other Spanish-speaking countries.

The present study sample consisted of 502 neurologically and psychologically healthy participants with a mean age of 29.06 (SD = 13.41) with 14.75 years of education completed (SD = 3.01). Participants were divided into five different groups based on their country of birth and current country residency (i.e., United States, Mexico, Guatemala, Argentina, & Colombia). All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in Spanish. The CNT consisted of 30 black and white line drawings, ranging from easy to hard in difficulty. An ANCOVA, controlling for gender, education, and age, was used to evaluate CNT performance between the five Spanish-speaking country groups. Meanwhile, a Bonferroni post-hoc test was utilized to evaluate the significant differences between Spanish-speaking groups. We used a threshold of p < .05 for statistical significance.

Results revealed significant group differences between the five Spanish speaking groups on the CNT, p = .000, np2 = .48. Bonferroni post-hoc test revealed that the United States group significantly underperformed on the CNT compared to all the Spanish-speaking groups. Next, we found the Guatemalan group underperformed on the CNT compared to the Argentinian, Mexican, and Colombian groups. Additionally, we found the Argentinian group outperformed the Mexican, Guatemalan, and United States groups on the CNT. No significant differences were found between the Argentinian group and Colombian group or the Mexican group and Colombian group on the CNT.

As predicted, the Argentinian group outperformed all the Spanish-speaking groups on the CNT except the Colombian group. Additionally, we found that the United States group underperformed on the CNT compared to all the Spanish-speaking groups. A possible explanation is that Spanish is not the official language in the United States compared to the rest of the Spanish-speaking groups. Meanwhile, a possible reason why the Argentinian and Colombian groups demonstrated better CNT performances might have been that it was less culturally sensitive than the United States, Mexican, and Guatemalan groups. Further analysis is needed with bigger sample sizes across other Spanish-speaking countries (e.g., Costa Rica, Chile) to evaluate what variables, if any, are influencing CNT performance.

The American Academy of Clinical Neuropsychology’s (AACN) Relevance 2050 Initiative goals highlight the need for new assessment methods that are inclusive of the rising heterogeneous population in the US. In 2022, the Texas Education Agency reported that approximately 20% of the student population in Texas public schools are English learners (ELs), and approximately 90% of them are Spanish-speaking. In an effort to address the need for more Spanish cognitive measures normed in the US, a pediatric neuropsychology research team in North Dallas developed the Spanish Verbal Memory Test for Children (SVMT-C). To assist with establishing its validity, this study aims to corroborate that the words chosen for the list are familiar to children of different cultural backgrounds in North Texas.

Enrollment of healthy, Spanish-speaking children between 6.0 and 17.11 years old within the Dallas Fort-Worth (DFW) metroplex began in January 2022 and continues to date. Study participation entails completing an in-person testing session with the child, while the parent/legal guardian completes a word-related survey along with other forms. The parent survey asks parents to indicate their child’s knowledge of 45 words (15 are target words). The testing session with the child includes completion of several cognitive tests (e.g., SVMT-C, EOWPVT-4:SBE) and a posttest survey that measures the child’s knowledge of the target words on the SVMT-C. The EOWPVT-4:SBE was used to estimate vocabulary level in Spanish to support proficiency determinations.

To date, 23 parent-child dyads have participated in the study, and 7 different countries of origin are represented in the overall sample. Data of children who earned SS<85 in Spanish on the vocabulary test were omitted, leaving the pediatric sample at n=20. Ages ranged between 6.2 and 15.2 years old. Eighteen children were bilingual, one was monolingual, and one was multilingual. Only Spanish-speaking parents completed the Spanish Verbal Memory Test Survey, leaving the parent sample at n=21. The child survey revealed that 95% of the children (19 of 20) knew all 15 target words; only one 6-year-old child did not know a word, which contradicted their parent’s report. The parent survey revealed that 90% of parents reported their child knew all 15 target words and 100% of parents reported their child knew 14 of 15 words; only two parents (19 of 21) were unsure if their child knew one of the words but the child then earned a score of 100% on their survey.

Creating a verbal memory measure in Spanish for use in the US presents a set of unique challenges because of the variability in terminology that exists in the language. Lack of familiarity with terminology may influence performance and invalidate results. In this endeavor, the goal was to recognize these nuances and create a relevant measure that uses common words for Spanish-speaking children regardless of cultural background. Thus far, the data supports the appropriateness of the words listed in the SVMT-C with a 100% familiarity rate among children ages 7 to 15 years old.

Neurocognitive decline is prevalent in patients with metastatic cancers, attributed to various disease, treatment, and individual factors. Whether the presence of brain metastases (BrMets) contributes to neurocognitive decline is unclear. Aims of this study are to examine neurocognitive performance in BrMets patients and compare findings to patients with advanced metastatic cancer without BrMets. Here, we present baseline findings from an ongoing, prospective longitudinal study.

English-speaking adults with advanced metastatic cancers were recruited from the brain metastases and lung clinics at the Princess Margaret Cancer Centre. Participants completed standardized tests (WTAR, HVLT-R, BVMT-R, COWAT, Trailmaking test, WAIS-IV Digit Span) and questionnaires (FACT-Cog v3, EORTC-QLQ C30 and BN20, PROMIS Depression(8a) and Anxiety(6a)) prior to cranial radiotherapy for those who required it. Test scores were converted to z-scores based on published normative data and averaged to create a composite neurocognitive performance score and domain scores for memory, attention/working memory, processing speed and executive function. Neurocognitive impairment was defined according to International Cancer and Cognition Task Force criteria. Univariate and multivariate regressions were used to identify individual, disease and treatment variables that predict cognitive performance.

76 patients (mean (SD) age: 63.2 (11.7) years; 53% male) with BrMets were included. 61% experienced neurocognitive impairment overall; impairment rates varied across domains (38% memory, 39% executive functioning, 13% attention/working memory, 8% processing speed). BrMets quantity, volume, and location were not associated with neurocognitive performance. Better performance status (ECOG; ß[95%CI];-0.38[-0.70,-0.05], p=0.021), higher premorbid IQ (0.34[0.10,0.58], p=0.005) and greater cognitive concerns (0.02[-3.9e-04,0.04], p=0.051) were associated with better neurocognitive performance in univariate analyses. Only premorbid IQ (0.37[0.14,0.60], p=0.003) and cognitive concerns (0.02[0.0004, 0.03], p=0.05) remained significant in multivariate analysis. We also recruited 31 patients with metastatic non-small cell lung cancer (mNSCLC) with no known BrMets (age: 67.5 (8.3); 32% male) and compared them to the subgroup of BrMets patients in our sample with mNSCLC (N=32; age: 67.8 (11.7); 53% male). We found no differences in impairment rates (BrMets/non-BrMets: Cognitive Composite, 59%/55%; Memory, 31%/32%; Executive Functioning, 35%/29%; Attention/working memory, 16%/13%; Processing speed, 7%/6%; Wilcoxon rank-sum test, all p-value’s > 0.5). The presence or absence of BrMets did not predict neurocognitive performance. Among patients with mNSCLC, higher education (0.11[0.03,0.18], p=0.004) and premorbid IQ (0.36[0.12,0.61], p=0.003), fewer days since primary diagnosis (0.00290[-0.0052,-0.0005], p=0.015) fewer pack-years smoking history (0.01[0.02,-0.001], p=0.027) and greater cognitive concerns (0.02[7e-5,0.04], p=0.045) were associated with better neurocognitive performance in univariate analyses; only premorbid IQ (0.26[0.02,0.51], p=0.04) and cognitive concerns (0.02[0.01,0.04], p=0.02) remained significant in multivariate analysis.

Cognitive impairment is prevalent in patients with advanced metastatic cancers, particularly affecting memory and executive functioning. However, 39% of patients in our sample were not impaired in any domain. We found no associations between the presence of BrMets and neurocognitive function in patients with advanced cancers prior to cranial radiation. Premorbid IQ, a proxy for cognitive reserve, was associated with cognitive outcomes in our sample. Our longitudinal study will allow us to identify risk and resilience factors associated with neurocognitive changes in patients with metastatic cancers to better inform therapeutic interventions in this population.

Metacognition refers to one’s ability to make online, in-the-moment judgments regarding their own cognitive performance, and has significant implications for one’s abilities to function in daily life. It has been documented that individuals with TBI often present with metacognitive deficits, and are slower than neurotypical peers in making such judgments. Preliminary attempts have been made to determine how neural contributions to metacognitive functioning differ after injury. Studies thus far have found unique roles of prefrontal gray matter volume and inter-network connectivity in metacognitive functioning after injury, but functional activation directly associated with metacognitive processing has yet to be investigated. This event-related functional magnetic resonance imaging (fMRI) study aimed to document differences in functional activation between adults with TBI and neurotypical peers when completing metacognitive confidence judgments.

16 adults with moderate to severe TBI and 10 healthy adults (HCs) completed a metacognitive task while in the fMRI scanner. All participants were exposed to target slides with polygons arranged in various positions, then asked to identify the target slide from a group including 3 other distractor slides. Following each response, participants provided a metacognitive retrospective confidence judgment (RCJ) by rating their confidence that the answer they provided was correct. Meta d', a signal-detection based metric of metacognitive accuracy, was calculated. FSL FEAT was used for processing and analysis of the imaging data. Contrasts were created to model activation that was greater when RCJs were made compared to target recognition, mixed effects modeling was then used to investigate group differences. Cluster based thresholding set to z>2.3, p<0.01 was used for multiple comparisons correction.

Healthy controls performed significantly better on the target identification task (p<0.01), and were faster at making RCJs (p=0.03). Individuals with TBI had greater meta d’ scores (p=0.03). Significant activation beyond what was present during target recognition (RCJ>recognition) was found in left supramarginal gyrus, left posterior cingulate, and left cerebellum when individuals with TBI made RCJs, while HCs showed significant activation in the left precuneus, and bilateral superior temporal gyri. Individuals with TBI demonstrated more activation in the lateral occipital cortex bilaterally and the left cerebellum than HCs when completing RCJs. HCs presented with more activation in the left supramarginal gyrus than the TBI group when making RCJs.

The areas of activation present in both the TBI and HC groups are consistent with previous imaging findings from studies of healthy samples. Interestingly, two structures previously implicated in self-directed cognition and consciousness, the posterior cingulate and precuneus, were differentially activated by the groups. The lack of a common network between the two groups suggests that survivors may rely on separate neural substrates to facilitate metacognition after injury. The TBI group was found to recruit more functional areas when completing the RCJs. These findings, paired with the behavioral data indicating metacognitive performance differences, suggests that neural recruitment may occur after injury to allow for survivors to engage in making metacognitive judgments. Future qualitative investigations of the metacognitive judgments are needed to determine the compensatory nature of this postinjury recruitment.