Trait mindfulness is associated with reduced stress and psychological well-being. However, evidence regarding its effects on cognitive function is mixed and certain facets of trait mindfulness are associated with higher negative affect (NA). This study investigated whether specific mindfulness skills were associated with cognitive performance and affective traits.

165 older adults from the Maine Aging Behavior Learning Enrichment (M-ABLE) Study completed the National Alzheimer’s Coordinating Center T-Cog battery, the Five Facet Mindfulness Questionnaire, and the Positive and Negative Affect Schedule-SF.

All five facets of trait mindfulness were associated with higher Positive Affect and lower NA, with the exception that Observation was not associated with trait NA. Partial correlations adjusting for age indicated that better episodic memory was associated with Observation, Describing, and Nonreactivity. Verbal fluency performance was associated with Observation, while Working Memory was associated with Nonjudgment. Executive Attention/Processing speed was associated with total mindfulness scores and showed a trend relationship with Nonreactivity.

Mindfulness skills showed specific patterns with affective traits and cognitive function. These findings suggest that the ability to maintain awareness, describe, and experience internal and external states without reacting to them may partly rely on episodic memory. Mindful awareness skills also may depend on frontal and language functions, while the ability to experience emotional states without reacting may require Executive Attention. Global mindfulness and a non-judgmental stance may require auditory attention. Alternatively, mindfulness skills may serve to enhance these functions. Hence, longitudinal research is needed to determine the directionality of these findings.

Certain contextual factors, including non-restorative sleep (Niermeyer & Suchy, 2020), sleep deprivation (Lim & Dinges, 2010), burdensome emotion regulation (Franchow & Suchy, 2017), and pain interference (Boselie, Vancleef, & Peters, 2016) have been shown to contribute to temporary declines in executive functioning (EF). Contextually-induced decrements in EF in turn have been associated with temporary decrements in performance of instrumental activities of daily living (IADLs) among healthy older adults (Brothers & Suchy, 2021; Suchy et al., 2020; Niermeyer & Suchy 2020). Furthermore, some evidence suggests that higher variability in levels of contextual factors across days (i.e., deviations from routine) may contribute to IADL lapses above and beyond average, albeit high, levels of these contextual burdens (Bielak, Mogle, & Sliwinksi, 2019; Brothers & Suchy, 2021). Taken together, these findings highlight the importance of accounting for transient contextual burdens when assessing EF and IADL abilities in older adults.

Poor sleep quality has been associated with poor IADL performance (Fung et al., 2012; Holfeld & Ruthing, 2012) when assessed in a single visit. However, the potential contributions of variable sleep quantity and quality on IADL performance have not been assessed in healthy older adults using longitudinal methods. Accordingly, the aim of this study was to examine the impact of fluctuations in sleep quantity and quality, assessed daily, above and beyond average levels, on at-home IADL performance across 18 days in a group of community-dwelling older adults.

Fifty-two non-demented community-dwelling older adults (M age = 69 years, 65% female) completed 18 days of at-home IADL tasks, as well as daily ecological momentary assessment (EMA) measures of EF, sleep hours, and restfulness questions. An 18-day mean EMA EF score was computed controlling for practice effects. Mean levels of and variability in EMA sleep hours and EMA restfulness ratings were computed. IADL scores were computed for timeliness and accuracy across the 18 days.

A series of hierarchical linear regressions were run using separate IADL timeliness and accuracy as the dependent variable. In the first step, demographics (age, sex, education) were entered. Then, EMA EF was entered, followed by mean EMA sleep hours and EMA mean restfulness, and lastly, variability in EMA sleep hours and EMA restfulness. EMA EF was found to significantly predict both IADL accuracy (B = .46, p = .001) and timeliness (B = .45, p = .005). Variability in EMA sleep hours (B = .40, p = .008) and restfulness (B = -.29, p = .043) both predicted IADL accuracy beyond other variables, while mean levels did not. Additionally, variability in sleep hours and restfulness substantially improved the prediction of IADL accuracy above and beyond other variables in the model, accounting for an additional 16% of variance (F (2) = 3.80, ∆ R2 = .16, p = .006). Neither mean levels of or variability in sleep hours or restfulness predicted IADL timeliness.

Results suggest that greater fluctuations in the amount and quality of sleep across days may render healthy older adults more susceptible to lapses in daily functioning abilities, particularly the accuracy with which IADL tasks are completed.

Lower levels of social support in persons with Multiple Sclerosis (PwMS) are associated with myriad poor outcomes including worse mental health, lower quality of life, and reduced motor function (Kever et al., 2021). Social support has also been associated with physical pain (Alphonsus et al., 2021) and sleep disturbance (Harris et al., 2020) in PwMS. Pain is one of the most common symptoms of MS (Valentine et al., 2022) and is also known to be related to sleep disturbance (Neau et al., 2012). With these considerations in mind, the goal of the current study was to examine social support as a possible moderator in the relationship between pain and sleep quality in PwMS.

This cross-sectional study included 91 PwMS (females = 76). A neuropsychological battery and psychosocial questionnaires were administered. For sleep quality a composite was created from the sleep and rest scale of the Sickness Impact Profile (SIP), sleep-related items on the Multiple Sclerosis-Symptom Severity Scale (MS-SSS) (i.e., sleeping too much or sleep disturbance, fatigue or tiredness, and not sleeping enough), and an item from the Sleep Habits Questionnaire (SHQ) ("How many nights on average are you troubled by disturbed sleep?"). This composite (a = .76) has been used in prior research. Lower scores were indicative of worse sleep quality. Pain intensity and pain interference were measured using the Brief Pain Inventory (BPI). Pain intensity was calculated from four pain indices (i.e., pain at its worst in the last 24 hours, at its least in the last 24 hours, on average, and current pain at the time of the assessment) and pain interference was calculated from seven indices (i.e., general activity, mood, walking ability, normal work, relationships with others, sleep, and enjoyment of life). The Social Support Questionnaire (SSQ) measured average satisfaction with supports. A series of hierarchical linear regressions were conducted with the sleep quality index as the outcome variable and satisfaction with social supports, both indices of pain (intensity and interference), and their interactions as predictors. Then, simple effects tests were used to clarify the pattern of any significant interactions.

Regression analysis revealed that the interaction between pain interference and satisfaction with social support was significant (p = .034). Simple effects tests revealed that when satisfaction with social support was high, pain interference was associated with better sleep quality (p < .001). The interaction between pain intensity and satisfaction with social supports was also significant (p = .014). Simple effects test revealed that at high levels of satisfaction with social supports, pain intensity was associated with better sleep quality (p < .001).

Satisfaction with social support moderated the relationship between pain interference and pain intensity on sleep quality in PwMS. Specifically, high satisfaction with social support buffers against the negative effects of pain interference and pain intensity on sleep quality in PwMS. This provides evidence that interventions aimed at increasing social supports in PwMS may lead improvements in sleep quality and reduce the impact of pain on sleep quality.

Attention is the backbone of cognitive systems and is requisite for many cognitive processes vital to everyday functioning, including memory, problem solving, and the cognitive control of behavior. Attention is commonly impaired following traumatic brain injury and is a critical focus of rehabilitation efforts. The development of reliable methods to assess rehabilitation-related changes are paramount. The Attention Network Test (ANT) has been used previously to identify 3 independent, yet interactive attention networks—alerting, orienting, and executive control (EC). We examined the behavioral and neurophysiological robustness and temporal stability of these networks across multiple sessions to assess the ANT’s potential utility as an effective measure of change during attention rehabilitative interventions.

15 healthy young adults completed 4 sessions of the ANT (1 session/7-day period). ANT networks were assessed within the task by contrasting opposing stimulus conditions: cued vs. non-cued trials probed alerting, valid vs. invalid spatial cues probed orienting, and congruent vs. incongruent targets probed EC. Differences in median correct-trial reaction times (RTs) and error rates (ERs) between the condition pairs were assessed to determine attention network scores; robustness of networks effects, as determined by one-sample t-tests at each session, against a mean of 0, determining the presence of significant network effects at each session. Sixty-four-channel electroencephalography (EEG) data were acquired concurrently and processed using Matlab to create condition-related event-related potentials (ERPs)—particularly the cue- and probe-related P1, N1, and P3 deflection amplitudes, measured by using signed-area calculation in regions of interest (ROIs) determined by observation of spherical-spline voltages. This enabled us to examine the robustness of cue- and probe-attention-network ERPs.

All three attention networks showed robust effects. However, only the EC RT and ER network scores remained significantly robust [t(14)s>13.9,ps<.001] across all sessions, indicating that EC is robust in the face of repeated exposure. Session 1 showed the greatest EC-RT robustness effect which became smaller during the subsequent sessions per ANOVAs on Session x Congruency [F(3,42)=10.21,p<.0001], reflecting persistence despite practice effects. RT robustness of the other networks varied across sessions. Alerting and EC ERs were similarly robust across all 4 sessions, but were more variable for the orienting network. ERP results: The cue-locked P1-orienting (valid vs. invalid) was generally larger to valid- than invalid-cues, but the robustness across sessions was variable (significant in only sessions 1 and 4 [t(14)s>2.13,ps<.04], as reflected in a significant main effect of session [p=.0042]. Next, target-locked EC P3s were generally smaller to congruent than incongruent targets [F(1,14)=9.40,p=.0084], showing robust effects only in sessions 3 and 4 [ps<.005].

The EC network RT and ER scores were consistently robust across all sessions, suggesting that this network may be less vulnerable to practice effects across session than the other networks and may be the most reliable probe of attentional rehabilitation. ERP measures were more variable across attention networks with respect to robustness. Behavioral measures of EC-network may be most reliable for assessing progress related to attentional-rehabilitation efforts.

Primary headache disorder is characterized by recurrent headaches which lack underlying causative pathology or trauma. Primary headache disorder is common and encompasses several subtypes including migraine. Vestibular migraine (VM) is a subtype of migraine that causes vestibular symptoms such as vertigo, difficulties with balance, nausea, and vomiting. Literature indicates subjective and performance-based cognitive problems (executive dysfunction) among migraineurs. This study compared the magnitude of the total effect size across neuropsychological domains to determine if there is a reliable difference in effect sizes between individuals with VM and healthy controls (HC). An additional aim was to meta-analyze neuropsychological outcomes in migraine subtypes (other than VM) in reference to healthy controls.

This study was a part of a larger study examining neuropsychological functioning and impairment in individuals with primary headache disorder and HCs. Standardized search terms were applied in OneSearch and PubMed. The search interval covered articles published from 1986 to May 2021. Analyses were random-effects models. Hedge’s g was used as a bias-corrected estimate of effect size. Between-study heterogeneity was assessed using Cochran’s Q and I2. Publication bias was assessed with Duval and Tweedie’s Trim-and-Fill method to identify evidence of missing studies.

The initial omnibus literature search yielded 6692 studies. Three studies (n=151 VM and 150 HC) met our inclusion criteria of having a VM group and reported neuropsychological performance. VM demonstrated significantly worse performance overall when compared to HCs (k=3, g=-0.99, p<0.001; Q=4.41, I2=54.66) with a large effect size. Within-domain effects of VM were: Executive Functioning=-0.99 (Q=0.62, I2=0), Screener=-1.15 (Q=3.29, I2=69.59), and Visuospatial/Construction=-1.47 (Q=0.001, I2=0.00). Compared to chronic migraine (k=3, g=-0.59, p<0.001; Q=0.68, I2=0.00) and migraine without aura (k=23, g=-0.39, p<0.001; Q=109.70, I2=79.95), VM was the only migraine subgroup to display a large effect size. Trim-and-fill procedure estimated zero VM studies to be missing due to publication bias (adjusted g=-0.99, Q=4.41).

This initial attempt at a meta-analysis of cognitive deficits in VM was hampered by a lack of studies in this area. Based on our initial findings, individuals with VM demonstrated overall worse performances on neuropsychological tests compared to HCs with the greatest level of impairment seen in visuospatial/construction. Additionally, VM resulted in a large effect size while other migraine subtypes yielded small to moderate effect sizes. Despite the small sample of studies, the overall effect across neuropsychological performance was generally stable (i.e., low between-study heterogeneity). Given than VM accounts for 7% of patients seen in vertigo clinics and 9% of all migraine patients, our results suggest that neuropsychological impairment in VM deserves significantly more study.

The serial position effect is the tendency to recall items at the beginning (primacy) and end (recency) of a word list best and middle items the worst, demonstrated by a 'U-shaped’ profile. Individuals with memory impairment often demonstrate a 'J-shaped’ profile, with a diminished primacy effect. An attenuated primacy effect could be one of the earliest indicators of cognitive decline in older adults. Chronic elevations in cortisol are related to hippocampal atrophy and decreased learning and recall. Given the rehearsal and encoding required to recall words at the beginning of a list, we hypothesized that reduced primacy would be related to higher cortisol levels, measured via hair cortisol concentration, in older adults, particularly caregivers of people with dementia (PWD), who are under increased stress.

Data were taken from a deidentified dataset of 60 community-dwelling older adults (> 50) with no evidence of dementia who participated in a larger study on memory and caregiving stress; 26 identified themselves as caregivers of PWD. The sample was 83% women and 98% White, with a mean age of 67.58 (SD=8.85) and 80% holding at least a college degree. Stress was measured with the Perceived Stress Scale. The List Learning and List Recall subtests from the Repeatable Battery for the Assessment of Neuropsychological Status were used to assess the serial position effect. Primacy and recency were determined by the first three and last three words on the list, respectively, and were measured for trials 1-4. Relative strength of primacy versus recency at delayed recall was also calculated such that positive scores indicate better primacy than recency and negative scores indicate worse primacy than recency (J-shaped profile). Hair samples were collected, and the first one cm of hair was used to assay hair cortisol concentration, reflecting the past month of cortisol.

Caregivers were younger than non-caregivers (p<.001), but groups did not differ in gender (p=.412). Age was controlled for in all subsequent analyses. Caregivers reported more stress (p<.001), but groups were not different in hair cortisol (p=.093). On memory tasks, caregivers showed lower list learning raw scores (p=.002) and lower list recall raw score (p=.046); groups were not different in primacy learning (p=.114), but caregivers showed worse recency over learning trials (p<.001). Caregivers were not more likely to show the J-shaped serial position profile at recall (p=.285). Collapsed across groups, perceived stress was not related to cortisol (p=.124) but was related to recency (p=.001) and list learning raw (p=.004), but not list recall raw (p=.485) or primacy (p=.109). Cortisol was not related to primacy (p=.277) or recency (p=.538).

Contrary to predictions, caregivers were not worse on primacy but were worse on recency. Caregivers also reported more stress; collapsed across groups, stress was associated with recency performance. This may suggest that stress is related more to poor attention and short-term memory (recency) than encoding and recall related memory problems (primacy).

Cognitive disengagement syndrome (CDS; previously known as “sluggish cognitive tempo” or SCT) refers to a set of behavioral symptoms characterized by slowed thinking/behavior, daydreaming, and mental fogginess or confusion. It has been described as related to, yet separate from, symptoms associated with Attention-deficit Hyperactivity Disorder (ADHD) inattention. There is a paucity of research on CDS within pediatric epilepsy populations despite substantial risk factors inherent to the disorder and a large proportion of patients with comorbid ADHD. This study therefore describes CDS as reported by parents for a large sample of children with epilepsy. Relationship between epilepsy variables (e.g., number of antiepileptic drugs [AEDs], seizure frequency, seizure type) and CDS symptoms was explored. Additionally, considering the negative association between CDS and academic performance in other populations, the relationship between parentrated CDS and academic risk factors was examined.

Participants included 151 children with epilepsy (mean age = 11y, range 6-18y; 55% male; IQ>70), referred for outpatient neuropsychological assessment. As part of routine clinical care, parents completed the Penny Sluggish Cognitive Tempo Scale (SCT) and the Colorado Learning Difficulties Questionnaire (CLDQ). Scores and basic demographic information were extracted from an IRB approved clinical database; the IRB granted approval for retrospective chart review to extract additional medical variables. Parent report of CDS included total CDS score and three subdomains: Sleepy/Sluggish, Low Initiation, and Daydreamy. Higher scores represent greater parent-reported difficulties. Independent samples t-tests compared the participants’ means on total CDS and each subdomain to the normative sample. Analysis of variance was conducted to determine differential impact of seizure type (Generalized, Focal, or Multifocal) on total CDS and each subdomain. Correlations between other medical variables, scores on the CLDQ, and parent ratings on the SCT were examined.

Parents of children with epilepsy rated overall CDS total and subdomain scores as significantly higher compared to the normative means with highest elevation in symptoms of Low Initiation (p = <.001). Total CDS was associated with increased parent-reported academic difficulties; however, of the three subdomains, only Low Initiation was significantly associated with concerns for academic functioning. Number of AEDs was associated with increased symptoms on the Sleepy/Sluggish subdomain only. Seizure frequency was associated with total CDS and Sleepy/Sluggish symptoms, though this finding is likely mediated by increased number of AEDs for those with more frequent seizures. Seizure type was not associated with significant differences in Total CDS or CDS subdomains.

Children with epilepsy are at increased risk for experiencing slowed thinking and cognitive disengagement. Low initiation is particularly elevated in pediatric epilepsy populations, which may lead to increased academic difficulties. Potential interventions targeting low initiation may therefore have benefit in the academic setting for children with epilepsy, regardless of epilepsy type.

There are many common beliefs within the general public about Chronic Traumatic Encephalopathy (CTE) that contradict research findings and scientific evidence. Therefore, the goal of this study was to examine the accuracy of CTE knowledge across three diverse samples.

The three groups included in the sample were 333 college students (54%), 196 individuals from the public (32%), and 90 psychology trainees/clinicians (54%) for a total of 619 participants. Online surveys were used to collect the CTE knowledge accuracy (i.e., the number correct divided by the total number of questions) of the sample. The questions about CTE were adapted from Merz et al. (2017) and from the Sports Neuropsychology Society’s “CTE: A Q and A Fact Sheet.”

Overall, CTE knowledge accuracy was 52% (M = 51%, SD = .24). Regarding inaccurate beliefs, two-thirds of the sample believed that CTE was related to sports participation alone even if a head injury did not occur, and most participants believed that CTE could be caused by a single injury. Additionally, confidence in CTE knowledge was positively correlated with willingness to allow their child to play a high contact sport despite overall low CTE knowledge accuracy. Last, many participants reported education (67%) and health care providers (61%) as their main sources of CTE information while only 18% of participants cited television/movies. However, when asked to provide additional details about their CTE information source, many participants cited ESPN specials and the movie “Concussion” as the main reason they learned of the condition and sought out additional information.

The results of this study are consistent with previous research on CTE knowledge accuracy. This further supports the need for clinicians and researchers to address misconceptions by providing information and scientific facts.

Motor skills have been linked to executive functions (EFs) in typically developing school-, and preschool-age children. Yet fine motor skills have been more consistently correlated with EFs than gross motor skills, perhaps because they are more frequently investigated. Preterm born children are vulnerable to deficits in both gross and fine motor skills, even after exclusion of neurological cases. In addition to motor skills, EFs may also be compromised in preterm born preschoolers. Because premature birth increases the odds for atypical brain development, and since adverse effects on brain functioning tend to yield increased dispersion of performance scores, we wished to determine whether fine and gross motor skills are differentially linked to performance on tasks measuring EF skills in nonhandicapped preschoolers born preterm.

We studied 99 preterm (born < 34 weeks) singleton preschoolers (3-4 years of age; 50 females), all graduates of the Neonatal Intensive Care Unit at William Beaumont Hospital, Royal Oak, MI. Motor skills were assessed with the Peabody Developmental Motor Scales - (Second Edition) which provide Fine and Gross Motor Quotients (FMQ, and GMQ, respectively). Three core EFs were measured: working memory, motor inhibition, and verbal fluency. Working memory skills were assessed with two Clinical Evaluation of Language Fundamentals - Preschool -Second Edition subtests: Recalling Sentences (RS) and Concepts and Following Directions (CFD). Motor inhibition and verbal fluency were assessed with the NEPSY-II Statue and Word Generation (WG) subtests, respectively. Children with a history of moderate to severe intracranial pathology or cerebral palsy were excluded.

We conducted linear regression analyses using scaled scores from the Statue, WG, RS, and CFD subtests as the predicted variables. Predictors of interest were the FMQ and GMQ. We adjusted for sociodemographic factors (SES and sex) and perinatal risk (gestational age, sum of antenatal complications and birth weight SD). The GMQ was significantly associated with all four EF measures (Statue, t(84) = 4.13, p < .001; CFD, t(92) = 3.83, p < .001; WG, t(84) = 3.38, p = .001; RS, t(90) = 3.37, p = .001). The FMQ was significantly associated with three of four EF measures (Statue, t(84) = 3.41, p = .001; CFD, t(92) = 3.97, p < .001; WG, t(84) = 1.96, p = .054; RS, t(90) = 2.91, p = .005).

Both fine and gross motor skills were associated with EF in nonhandicapped preterm-born singletons. Lower motor functioning in either motor domain was linked to reduction in performance on diverse EF measures. It should be emphasized that motor performance contributed to explaining variance in EFs even after statistical adjustment for early medical risk. In addition to the obvious conclusion that motor skills may underpin EF skills, it is likely that early risk factors not captured by the medical risk variables used in our analyses were nonetheless tapped by variability in motor performance. As preschool EFs are essential for subsequent academic performance, the significance of age-appropriate motor development in the preschool age should not be underestimated in our at-risk population.

Previous research has found that measures of premorbid intellectual functioning may be predictive of performance on memory tasks among older adults (Duff, 2010). Intellectual functioning itself is correlated with education. The purpose of this study was to investigate the incremental validity of a measure of premorbid intellectual functioning over education levels to predict performance on the Virtual Environment Grocery Store (VEGS), which involves a simulated shopping experience assessing learning, memory, and executive functioning.

Older adults (N = 118, 60.2% female, age 60-90, M = 73.51, SD = 7.46) completed the Wechsler Test of Adult Reading and the VEGS.

WTAR and education level explained 9.4% of the variance in VEGS long delay free recall, F = 5.97, p = 0.003). WTAR was a significant predictor (ß = 0.25, p = 0.006), while level of education was not.

These results suggest that crystalized intelligence may benefit recall on a virtual reality shopping task.

Although some animal research suggests possible sex differences in response to THC exposure (e.g., Cooper & Craft, 2018), there are limited human studies. One study found that among individuals rarely using cannabis, when given similar amounts of oral and vaporized THC females report greater subjective intoxication compared to males (Sholler et al., 2020). However, in a study of daily users, females reported indistinguishable levels of intoxication compared to males after smoking similar amounts (Cooper & Haney, 2014), while males and females using 1–4x/week showed similar levels of intoxication, despite females having lower blood THC and metabolite concentrations (Matheson et al., 2020). It is important to elucidate sex differences in biological indicators of cannabis intoxication given potential driving/workplace implications as states increasingly legalize use. The current study examined if when closely matching males and females on cannabis use variables there are predictable sex differences in residual whole blood THC and metabolite concentrations, and THC/metabolites, subjective appraisals of intoxication, and driving performance following acute cannabis consumption.

The current study was part of a randomized clinical trial (Marcotte et al., 2022). Participants smoked ad libitum THC cigarettes and then completed driving simulations, blood draws, and subjective measures of intoxication. The main outcomes were the change in Composite Drive Score (CDS; global measure of driving performance) from baseline, whole blood THC, 11-OH-THC, and THC-COOH levels (ng/mL), and subjective ratings of how “high” participants felt (0 = not at all, 100 = extremely). For this analysis of participants receiving active THC, males were matched to females on 1) estimated THC exposure (g) in the last 6 months (24M, 24F) or 2) whole blood THC concentrations immediately post-smoking (23M, 23F).

When matched on THC exposure in the past 6 months (overall mean of 46 grams; p = .99), there were no sex differences in any cannabinoid/metabolite concentrations at baseline (all p > .83) or after cannabis administration (all p > .72). Nor were there differences in the change in CDS from pre-to-post-smoking (p = .26) or subjective “highness” ratings (p = .53). When matched on whole blood THC concentrations immediately after smoking (mean of 34 ng/mL for both sexes, p = .99), no differences were found in CDS change from pre-to-post smoking (p = .81), THC metabolite concentrations (all p > .25), or subjective “highness” ratings (p = .56). For both analyses, males and females did not differ in BMI (both p > .7).

When male/female cannabis users are well-matched on use history, we find no significant differences in cannabinoid concentrations following a mean of 5 days of abstinence, suggesting that there are no clear biological differences in carryover residual effects. We also find no significant sex differences following ad libitum smoking in driving performance, subjective ratings of “highness,” nor whole blood THC and metabolite concentrations, indicating that there are no biological differences in acute response to THC. This improves upon previous research by closely matching participants over a wider range of use intensity variables, although the small sample size precludes definitive conclusions.

The current study had two primary objectives: 1) To assess the dose-response relationship between acute bouts of aerobic exercise intensity and performance in multiple cognitive domains (episodic memory, attention, and executive function) and 2) To replicate and extend the literature by examining the dose-response relationship between aerobic exercise intensity and pattern separation.

18 young adults (mean age = 21.6, sd = 2.6; mean education = 13.9, sd = 3.4; 50% female) were recruited from The Ohio State University and surrounding area (Columbus, OH). Participants completed control (no exercise), light intensity, and vigorous intensity exercise conditions across three counterbalanced appointments. For each participant, all three appointments occurred at approximately the same time of day with at least 2 days between appointments. Following the rest or exercise conditions and after an approximately 7 minute delay, participants completed a Mnemonic Similarity Task (MST; Stark et al., 2019) to assess pattern separation. This task was always administered first as we attempted to replicate previous studies and further clarify the relationship between acute bouts of aerobic exercise and pattern separation by implementing an exercise stimulus that varied in intensity. After the MST, three brief cognitive tasks (roughly 5 min each) were administered in a counterbalanced order: a gradual-onset continuous performance task (gradCPT; Esterman et al., 2013), the flanker task from the NIH toolbox, and a face-name episodic memory task. Here we report results from the gradCPT, which assesses sustained attention and inhibitory control. Heart rate and ratings of perceived exertion were collected to validate the rest and exercise conditions. Repeated-measures ANOVAs were used to assess the relationship between exercise condition and dependent measures of sustained attention and inhibitory control and pattern separation.

One-way repeated-measures ANOVAs revealed a main effect of exercise condition on gradCPT task performance for task discrimination ability (d') and commission error rate (p’s < .05). Pairwise comparisons revealed task discrimination ability was significantly higher following the light intensity exercise condition versus the control condition. Commission error rate was significantly lower for both the light and vigorous exercise conditions compared to the control condition. For the MST, two-way repeated-measures ANOVAs revealed an expected significant main effect of lure similarity on task performance; however, there was not a significant main effect of exercise intensity on task performance (or a significant interaction).

The current study indicated that acute bouts of exercise improve both sustained attention and inhibitory control as measured with the gradCPT. We did not replicate previous work reporting that acute bouts of exercise improve pattern separation in young adults. Our results further indicate that vigorous exercise did not detrimentally impact or improve pattern separation performance. Our results indicate that light intensity exercise is sufficient to enhance sustained attention and inhibitory control, as there were no significant differences in performance following light versus vigorous exercise.

Determine the classification concordance between a standalone performance validity test (PVT) and embedded PVTs from multiple cognitive domains.

Participants were 106 patients (49.1% female; 69% white) that underwent neuropsychological evaluation at an outpatient university doctoral clinical psychology training and research clinic (M/SD: age = 32.38/11.95; education = 13.7/2.75). A comprehensive neuropsychological battery included the Medical Symptom Validity Test (MSVT) and embedded PVTs from different cognitive domains: attention - Wechsler Adult Intelligence Scale - Fourth Edition Reliable Digit Span and Digit Span age-corrected scaled score (DS ACSS); memory - California Verbal Learning Test, 3rd Edition (CVLT-3) Forced-Choice Recognition (FCR), executive functions -Wisconsin Card Sorting Test (WCST) Failure to Maintain Set (FMS); visual-spatial/construction -Rey Complex Figure Test (RCFT) Copy raw score; language - Boston Diagnostic Aphasia Examination Complex Ideation Material (CIM); and motor functions - Finger Tapping Test (FTT). All participants were administered the MSVT but not all participants were administered all seven embedded PVTs. Credible/noncredible classification concordance rates and kappa correlations (i.e., percentage of agreement) were computed for each pairwise PVT combination.

Twenty-two percent (n = 23) of the sample failed at least one PVT, with 17.0% (n = 18) failing at least two. DS ACSS was the embedded PVT with the highest MSVT concordance rate at 92.4% and a fair kappa coefficient of .39; WCST FMS had the lowest concordance with MSVT at 82.9% and a slight kappa coefficient of .19. The highest concordance among embedded PVTs from different cognitive domains was CVLT-3 FCR and RCFT Copy raw score at 89.7% with a fair kappa coefficient of .35; the lowest agreement among embedded PVTs was WCST FMS and FTT at 74.0% with a kappa coefficient of -.02. More conservative kappa coefficients among all pair-wise embedded PVT combinations from different cognitive domains ranged from -.02 to .36. For all standalone and embedded PVT pairwise concordance rates, only two fell below the recommended minimum agreement of 80%: FCR vs. FMS = 79.3% and FMS vs. FTT = 74.0%.

Embedded PVTs across various cognitive domains have high agreement with a standalone PVT to aid in classifying noncredible performance, in the 83-92% range. Embedded PVTs from different cognitive domains also have mostly high agreement classification rates amongst themselves in aiding to determine noncredible performance, in the 74-90% range, with the lowest agreement rate between executive function and motor tests at 74%. More conservative kappa-based agreements between PVT pair-wise combinations were fairly consistent with other studies, with most being in the fair range. Finally, these findings indicate about a 17% base rate of noncredible cognitive performance in an outpatient university-based clinic.

People differ in their propensity to engage in risky behaviors. Numerous factors such as cognition and personality have been utilized in predicting risk-taking, but little is known about the influence of stable emotional competencies, such as Emotional Intelligence (EI), in risk-taking. EI is defined as the ability and capacity to understand, perceive, and manage one's own, as well as others', emotions. However there has been little published research on the effect of ability emotional intelligence in engaging in risk- taking behavior. We hypothesized that those with higher emotional intelligence ability scores would demonstrate higher and more optimal risk-taking propensity. Furthermore, as prior research has demonstrated that males engage in more risk-taking behaviors, we accounted for sex differences within our analysis.

One-hundred and twelve healthy adults completed this study, including 56 females (Mage=21.7, SD=5.8) and 56 males (Mage=21.5, SD=3.2). The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) was used to assess total EI ability while the Balloon Analog Risk Task (BART) was used to assess risk-taking propensity. We specifically analyzed adjusted number of pumps on unexploded balloons throughout the BART to account for the increased risk. We conducted Pearson correlations and a multiple regression to assess the if ability emotional intelligence and gender significantly predicted risk-taking propensity.

There was a significant correlation between total emotional intelligence ability score and adjusted number of pumps on the BART for females, r(55)=.362, p = .006, but not for males r(55)=.053, p=.701, suggesting that females who score higher in emotional intelligence ability also had a higher risk-taking propensity. Due to these findings, we conducted a multiple regression to assess if ability emotional intelligence and gender significantly predict risk-taking propensity on the BART. The results of the regression indicated the two predictors explained 9.0% of the variance (R2 =.09, F(2,108)=5.32, p<.01). However, it was found that ability emotional intelligence significantly predicted risk-taking propensity (β = .23, p<.05), but not sex (β = -.17, p=.06). There was no sex x EI interaction.

Higher ability emotional intelligence was significantly related to greater risk-taking propensity, but this was only observed for females. However, the lack of significance of sex in significantly predicting risk-taking may just be due to lower statistical power in the study. Importantly, the adjusted number of pumps for the participants in this sample was generally far below the mid-point for popping balloons, suggesting that the higher scores observed here represent more optimal decision performance rather than just greater risk. Thus, greater EI may reflect greater capacity to learn from reward and punishment feedback and apply that learning to optimize performance. Future research should look at the effect of emotional intelligence training in improving optimal risk-taking, particularly for populations known for engaging in risky behaviors such as those with mTBI.

Anti-N-methyl-D-aspartate receptor encephalitis (ANMDARE) is a rare and progressive neurological autoimmune disease that disproportionally affects pediatric patients (Yeshokumar et al., 2022). Patients diagnosed with ANMDARE experience a host of neurocognitive and psychiatric sequelae, but data on the rate of recovery are generally mixed (Wilkinson-Smith et al., 2022). Misdiagnosis of ANMDARE is common and may complicate recovery given the progressive nature of the syndrome (Shimoyama et al., 2016); thus, knowledge of the etiology may result in enhanced resolution of symptoms. The current study assessed the rate of functional recovery for pediatric patients diagnosed with ANMDARE and admitted to an inpatient rehabilitation program. Specifically, we hypothesized that patients with idiopathic autoimmune encephalitis (IAE) would have a protracted rate of acute recovery compared to patients diagnosed with ANMDARE.

The current study included archival data of pediatric patients (N=10) aged 3-16 years (M=12.39, SD=4.97) admitted to an inpatient rehabilitation program at a metropolitan academic medical center between 2017-2022; of these patients, 7 were characterized as having IAE, 5 were female-at-birth, and 7 were of Hispanic/Latine origin. The Functional Independence Measure for Children (WeeFIM; Msall et al., 1994) domain scores (i.e., cognition, self-care, mobility, motor) were utilized to assess acute recovery. Welch’s t-tests were analyzed separately at admission and discharge between etiological conditions (i.e., idiopathic vs. known) for each WeeFIM domain. Subsequently, change scores were calculated across the length of inpatient stay for each WeeFIM domain, and Welch’s t-tests determined statistical differences in change scores between etiological conditions.

Contrary to predictions, WeeFIM self-care domain scores were significantly higher at inpatient admission for patients with IAE (M=27.57) as compared to patients with ANMDARE (M=13.00), t(7) = 1.95, p < .05; trending differences were also found in admission scores on the WeeFIM motor domain between IAE (M=43.86) and ANMDARE (M=24.00) diagnostic groups, t(6) = 1.71, p = .07. Consistent with predictions, patients with ANMDARE generally had an appreciable acute recovery as compared to patients with IAE. Specifically, trending differences were found in change scores on the WeeFIM self-care domain between IAE (M=10.29) and ANMDARE (M=30.33) diagnostic groups, t(6) = -1.64, p = .05. Likewise, trending differences were found in change scores on the WeeFIM motor domain between IAE (M=21.43) and ANMDARE (M=47.67) diagnostic groups, t(5) = -1.82, p = .06. No significant or trending differences were observed at discharge.

Results have implications for optimizing the assessment and treatment of pediatric patients diagnosed with autoimmune encephalitis. Specifically, patients with ANMDARE may have a more severe initial presentation yet improved recovery course compared to patients characterized as idiopathic during their inpatient stay, particularly in motor and self-care functional domains; data highlights the importance of inpatient rehabilitation for patients diagnosed with ANMDARE. Current limitations include small sample sizes across diagnostic groups, likely due to the rarity of the disease. It is recommended that future research investigate the prognosis of pediatric patients diagnosed with autoimmune encephalitis longitudinally, at follow-up and across the lifespan.

Neurofibromatosis type 1 (NF1) is a neurogenetic disorder associated with increased risk of neuropsychological challenges. While research has evidenced associations between environmental factors and neurocognitive development, few studies have examined the role that socioeconomic status (SES) plays on neuropsychological development in NF1. The aim of this study is to examine the relationship between community SES and cognitive/psychosocial outcomes in a neuropsychology clinic sample of pediatric NF1 patients.

The sample consisted of 47 youth with NF1 (M age=11.91, SD=3.69). The sample was 51.1% female, 72.3% White, 19.1% Black/African American, and 4.3% Hispanic. All participants had completed neuropsychological assessments for clinical purposes at an outpatient clinic in an urban, midwestern medical center. Data from neuropsychological measures and demographic information were pulled from records and entered into a de-identified dataset. The Wechsler Intelligence Scales, California Verbal Learning Test (CVLT), Woodcock Johnson Test of Achievement, and parent- and teacher-report versions of the Behavior Assessment System for Children (BASC) and the Behavior Rating Inventory of Executive Function (BRIEF) were used to examine broad neuropsychological functioning. The Area Deprivation Index (ADI) measures SES at the community level, as opposed to the individual level. It is composed of 17 factors related to education, poverty, employment, and housing. This information is used to assign index scores by zip code, with scores on a scale of 110 and 10 indicating the highest level of socioeconomic disadvantage. Mean ADI for this sample was 4.02 (SD=1.93).

Mean neurocognitive scores were consistently in the low average to average range. Parent and teacher scores on the BASC were in the average range. Mean scores on the BRIEF indicated Global Executive Composite scores in the mildly and moderately elevated range for parents and teachers, respectively. Correlational analyses revealed significant associations between ADI scores and immediate recall performance on the CVLT (Trials 1-5; r=.37; p=.03) and the BRIEF Planning and Organization subscale (r=.35; p=.02). Both remained significant after controlling for FSIQ (CVLT: rFSIQ=.49, p=.003; BRIEF: rFSIQ=.38; p=.02).

Mean cognitive scores for the sample are consistent with existing literature demonstrating that individuals with NF1 are at risk of reduced functioning in several domains. Sample mean ADI of 4 indicates a relatively low level of disadvantage in this sample., ADI was significantly associated with two variables, and greater deprivation was associated with better list learning performance. This suggests that the role of community SES is likely nuanced in how it impacts neurocognitive development. Results provide mild evidence of an association between ADI and learning and planning/organization. However, limitations to the current study, including a small sample size, and the retrospective nature, likely limits a more detailed understanding of the true relationship between community resources and cognitive and psychosocial outcomes among children with NF1. Future research comparing larger low and high ADI samples is necessary to fully examine the relationship between these factors. With better understanding of how community SES may limit or support neurocognitive and psychological growth in this population, more effective interventions can be designed for this group whose members are at notable risk for cognitive and psychological challenges.

In South Africa, most of the cognitive tests employed for neuropsychological evaluation are those developed in educationally advantaged settings such as the US, but the normative data accompanying the tests are unsuitable for use with South African examinees who have a disadvantaged quality of education, and/or whose primary language is other than English. A recently completed collation of Africa-based normative data (Shuttleworth-Edwards & Truter, 2022) includes a chapter on Performance Validity Tests (PVTs) with proposed cut-off points to assist in the identification of noncredible performance. The aim of this study was to compare the cut-off points established using educationally disadvantaged South African nonclinical normative samples for which only specificity percentages are available, with those established using clinical samples with designated valid and invalid performers for which both specificity and sensitivity data are available. A further aim was to compare the Africa-based cut-off points with age-equivalent cut-off points where available for US-based data on the targeted tests.

The collation of Africa-based studies delineates cut-off scores for invalid test performance based on both nonclinical as well as clinical populations for three stand-alone PVTs especially developed to identify invalid performance including the Dot Counting Test (DCT), the Rey Fifteen Item Test (FIT), and the Test of Memory Malingering (TOMM); and three commonly employed cognitive tests for which there are embedded validity indicators including the Digit Span Age-Corrected Scaled Score (ACSS) and Reliable Digit Span (RDS), the Rey Auditory Verbal Learning Test (RAVLT), and the Trail Making Test A and B (TMT A and B). For studies using nonclinical norming data alone, specificity percentages to derive the cut-off points were set at a minimum of 90%. For studies using clinical samples specificity was set at a minimum of 90%, and the associated sensitivity percentages were reported indicating each test’s ability to correctly identify those with an invalid performance. The studies included participants stratified for both child and adult age groups (age 8 to 79 years) from South African educationally disadvantaged backgrounds. The data were tabled together for descriptive comparison purposes, including a column for the US-base cut-off points for equivalent age stages where available.

There was a high level of compatibility between the proposed cut-off points established for the South African nonclinical normative samples compared with those using clinical samples of designated valid and invalid performers. There was a trend for more lenient cut-offs for younger children and older adults compared to older children and younger adults. Compared with US-based data where available, adjustments towards leniency were called-for on all indicators.

Cut-off scores for invalid cognitive test performance can be verified by perusing data derived from nonclinical norming samples as well as those from clinical samples, although the latter have the advantage of providing the sensitivity data to demonstrate the efficacy of a proposed cut-off score for identifying noncredible test performance. Adjustments towards leniency need to be made for cut-off scores for young children and older adults within an educationally disadvantaged population, and for disadvantaged adult populations compared with US-based educationally advantaged populations.

Emotion regulation and functioning have well established links to substance use in adolescents. Yet limited research has investigated emotion regulation in very early substance initiators either on self-report or on behavioral measures (i.e., Emotional Stroop). Similarly, there are few prospective investigations of emotional functioning as a predictor of initiation. Given concerns of emotion difficulties preceding and predicting substance use onset, we aim to investigate emotional functioning difficulties in very early (ages 9–13) substance use initiators relative to sociodemographically matched controls, both after initiation and as a predictor of initiation. We hypothesize that initiators would demonstrate greater emotion dysregulation and decreased emotional functioning relative to controls.

ABCD Study Annual Release 4.0 was used. Participants included those who had data available at Y3 follow-up visit and youth-reported use of any full dose of a substance (n=148). Sociodemographic controls were then matched (n=148). General linear mixed effects models were run to assess emotional functioning at Y3 (Emotional Stroop response time and accuracy performance, youth-reported Emotion Regulation Questionnaire, and parent-reported Difficulties in Emotion Regulation Scale and Child Behavior Checklist externalizing and internalizing symptoms) by substance use group status controlling for random effects of family. Further, hierarchical linear models assessed CBCL emotional functioning from Y0 to Y3 predicting SU initiation at Y3, controlling for within-subject change.

At Y3, early substance use initiation predicted higher parent-reported externalizing symptoms significantly (estimate=5.88, p<.001). Substance use initiation also marginally predicted high parent-reported internalizing symptoms (estimate=2.29, p=.08) and DERS (estimate=0.02, p=.07). ERQ and Stroop performance were not significantly associated with group status (p's>.10). For externalizing symptoms predicting SU initiation, regardless of year (baseline through Y3) was significantly predictive of initiation (p's<.001). HLM demonstrated that externalizing symptoms at all time points resulted in the best predictive model (AIC=392.85, BIC=422.80, relative to models including all data through Y2, AIC=433.63, BIC=458.59).

Here we found externalizing symptoms and, to a lesser extent, internalizing symptoms and emotion dysregulation are associated with early substance use initiation. However, results are limited to parent report, despite the consideration of youth-report and a behavioral measure of emotion regulation, the Emotional Stroop task. Further, while marginal effects were found, downstream externalizing symptoms were a better predictor of later substance use initiation. While other metrics of emotion regulation have been linked to substance use in adolescence, emotion regulation abilities may change as a result of substance use, rather than a predictor of use, and thus needs monitoring over time.

Clinical and experimental neuropsychology patients are not always able to complete a given test due to limitations in their functioning and it can lead to frustration and time wasted, leading researchers to examine the value of metrics that can be derived earlier in a test so as to ascertain and salvage useful information. The Trail Making Test (TMT) is an oft-utilized test of executive function and has been the focus of such exploration (e.g., first error vs. time to complete Trails B which can be lengthy in dementia cases and lead to discontinuation and loss of scorable data; Christidi et al., 2013; Correia et al., 2015). The present retrospective study utilized archival chart review to examine the association between a patient's diagnosis and occurrence of the first error on Trails B (TB1err).

De-identified data was culled from adult private practice records (n=137) in the northeastern United States (the study was conducted in compliance with local IRB review). Trails A and B times, as well as Digit Span scores (for checking construct validity) were pulled from reports, and Trails B record forms were scored to extract the enumerated stimulus where any first error was observed in the patient's rendering of the trail connecting alternating numbers and letters. Paired t-tests compared the average TB1err of normative individuals (no diagnosis) with patients with a primary diagnosis of mood disorder, traumatic brain injury (TBI), mild cognitive impairment (MCI), or dementia. Additionally, Pearson's correlations were computed comparing TB1err with Trails B time, and another test of executive function (Digit Span backwards).

The order of diagnoses according to the average occurrence of the first error on Trails B (from later, to sooner occurrence) was as follows: normative (no diagnosis), mood disorder, TBI, MCI, and finally dementia. There was a significant difference on this first error metric (TB1err) when comparing normative and dementia patients (p = .03; 8.3 vs 4.2 for the average enumeration of 1st error on Trails B). Furthermore, significant correlations were found between this derived TB1err metric and Digit Span backwards (r = .31; p <.001) as well as overall TrailsB performance (r = -.39; p < .001).

The present study adds to a growing literature on the utility of deriving test metrics to maximize useful data for clinical and experimental neuropsychology. Results from this retrospective chart review indicate additional validity data to support the use of extracting the first error on Trails B as a way to salvage useful data even when a patient may not be able to complete the full TMT as designed. In this preliminary sample there was a significant difference found for normative vs. dementia patients on this derived TB1err metric and suggests it is worthy of additional research to see if it can reliably differentiate various diagnoses. We expect this finding will also be useful in experimental designs wherein time is often limited and loss of data due to incomplete testing might be avoided by extracting the first error on TrailsB.