Driving is a cognitively demanding activity commonly affected by brain injury and illness. Accurate driving assessment is essential for reducing risk, optimizing independence, and informing driving-related interventions. Virtual reality driving simulation (VRDS) enables safe, sensitive, objective, and standardized measurement of driving abilities. VRDS has been validated in relation to self-reports and driver records. However, self-reports are subjective, and driver records include only major events (collisions, violations). Video telematics platforms can measure naturalistic driving in a more objective and sensitive manner. The present study used video telematics to examine relationships between VRDS performance and directly observed naturalistic driving.

20 healthy adult drivers (ages 23-61, mean age=36; 75% women) completed a VRDS assessment that included 1) driving on a straight road, 2) following a truck on a highway, and 3) reacting to a child running into a street to retrieve a ball. Primary VRDS measures were 1) speed and lane management on the straight road; 2) speed and following distance management in the truck-following task; and 3) reaction time, stopping, and distance from the child in the child-ball task. Participants also completed 28 days of naturalistic driving with a video telematics platform in their vehicle. Driving events were detected automatically using accelerometer, GPS, and video data, and driving behaviors were coded by driving risk analysts. The primary naturalistic measure was the number of unsafe driving behaviors per hour driven; specific driving behaviors served as exploratory variables. We examined correlations between VRDS and naturalistic driving variables. Given limited statistical power, we reported correlations that were small-to-medium or greater (r>.2) in primary analyses and medium-to-large or greater (r>.4) in exploratory analyses.

On average, drivers exhibited approximately one unsafe driving behavior per hour (M=0.9, SD=0.9, range=0.1-2.7). Common behaviors were failing to stop, unsafe following distance, speeding, and cell phone use. No collisions occurred. Average lane position in VRDS (specifically, leftward deviation from the center of the lane) was correlated with more real-world unsafe driving behaviors per hour (r=.35, p=.13), as were higher average straight road speed (r=.26, p=.27), greater straight road speed variability (r=.28, p=.24), and failing to stop for the child in the child-ball task (r=.22, p=.36). In exploratory analyses, failing to stop for the child was associated with real-world distracted driving (r=.45, p=.047), greater lane position variability in VRDS was associated with real-world unsafe following distance (r=.57, p=.009), and greater speed variability in VRDS was associated with real-world seat belt non-use/misuse (r=.49, p=.03).

The present findings provide preliminary evidence that VRDS variables are related to directly observed naturalistic driving, supporting the potential utility of VRDS as a sensitive, ecologically valid driving evaluation tool. As the present study used a small sample of healthy drivers, further research will explore this topic in larger samples and in clinical populations, such as acquired brain injury. Future work will also investigate whether incorporating VRDS with conventional driving evaluation tools (e.g., neuropsychological tests, behind-the-wheel assessments) can enhance the ability of clinical driving evaluations to predict real-world risky driving.

Integration of neuropsychological services into multidisciplinary clinics for pediatric patients requiring neurocritical care has previously been shown to improve access to care and promote connection to vital services for children recovering from traumatic brain injuries or other serious insults or infections impacting the brain. As such, the objective of this study is two-fold. First, to explore the unique model of care provided by a neuropsychological inpatient service at the Medical College of Wisconsin/Children’s Wisconsin. Secondly, to describe the benefit of neuropsychology in the Brain Recovery Assessment and Interdisciplinary Needs Clinic (BRAIN) a neurocritical care outpatient follow-up multidisciplinary clinic.

Participants include N =298 pediatric inpatients from a Level 1 Pediatric Trauma center referred to the neuropsychological inpatient consultation service from February 2020 to July 2022. Qualitative methods were used to describe the flow and number of patients initially referred to the neuropsychological inpatient service and then those who followed up in outpatient neuropsychological care prior to and after the implementation of a multi-disciplinary clinic for children admitted to the Neurocritical Care Unit. Rates of follow-up with neuropsychological care were compared pre- and post-establishment of the multidisciplinary clinic. Additional analyses were conducted to explore factors known to impact follow-up with care post-hospitalization (e.g., socioeconomic status, race, ethnicity).

Prior to the establishment of the BRAIN clinic, approximately 60 to 70% of patients were referred for outpatient neuropsychological follow-up. Approximately 30% of patients referred to the inpatient neuropsychological service following the establishment of the BRAIN clinic were referred for multidisciplinary care, while 20% did not require additional intervention and 50% were referred for outpatient neuropsychological follow-up. Analyses indicated increased follow-up rates with neuropsychological care following the establishment of the BRAIN clinic.

Integration of neuropsychology into inpatient care and subsequent multidisciplinary settings for pediatric patients with traumatic brain injuries or other serious insults and CNS infections increased access to neuropsychological care. Additional clinical implications will be discussed.

Education is known to impact neuropsychological test performance, and self-reported years of education is often used in stratifying normative data. However, this variable does not always reflect education quality, particularly among underrepresented populations, and may overestimate cognitive impairment in individuals with low education quality. This cross-sectional study evaluated relative contributions of years of education and reading level to several verbally mediated assessments to improve interpretation of neuropsychological performance.

Data was obtained from the Vanderbilt Memory and Aging Project. Cognitively-unimpaired participants (n=175, 72±7 years, 59% male, 87% Non-Hispanic White, 16±2 years of education) completed a comprehensive neuropsychological protocol. Stepwise linear regressions were calculated using education and Wide Range Achievement Test (WRAT)-3 Reading subtest scores as predictors and letter fluency (FAS, CFL), category fluency (Vegetable and Animal Naming), the Boston Naming Test (BNT), and California Verbal Learning Test (CVLT)-II as outcomes to assess increase in variance explained by educational quality. Models covaried for age and sex. The False Discovery Rate (FDR) based on the Benjamini-Hochberg procedure (Benjamini & Hochberg, 1995) was used to correct for multiple comparisons.

The mean WRAT-3 score was 51±4 (range:37-57), indicating post-high school reading level. Education and WRAT-3 scores were moderately correlated (r=0.36, p<0.01). Both WRAT-3 and years of education independently predicted letter fluency (WRAT-3 p<0.001; education p<0.02), category fluency (WRAT-3 p<0.001; education p<0.05), and CVLT-II performance (WRAT-3 p-values<0.005; education p-values<0.02) in single predictor models. On BNT, WRAT-3 (p<0.001), but not education (p=0.06), predicted performance in single predictor models. In combined models with both WRAT-3 and education, WRAT-3 scores remained a significant predictor of FAS (WRAT-3 b=1.21, p<0.001; education b=0.006, p=0.99) and CFL performance (WRAT-3 b=1.02, p<0.001; education b=0.51, p=0.14). Both WRAT-3 (b=0.21, p=0.01) and years of education (b=0.35, p=0.03) predicted Animal Naming, while WRAT-3 (b=0.16,p=0.008), but not years of education (p=0.37), predicted Vegetable Naming. WRAT-3 was a significant predictor of BNT performance (b=0.21, p<0.001) but not years of education (p=0.65). WRAT-3 predicted CVLT-II learning (b=0.32, p=0.04), immediate recall (b=0.16, p=0.005), and delayed recall performances (b=0.15, p=0.005), while education did not (p-values>0.14). All significant results persisted after FDR correction. WRAT-3 scores explained an additional level of variance beyond the covariates and education alone for FAS (AR=18%), CFL (AR=13%), Animal Naming and Vegetable Naming (AR= 3%), BNT (AR=18%), and CVLT-II learning (AR=2%), immediate recall (AR=4%), and delayed recall (AR=3%).

Reading level more strongly associated with performance on several verbally mediated neuropsychological measures than years of education. For all measures, the addition of reading level significantly increased the amount of variance explained by the model compared to covariates and education alone, which aligns with existing research. However, most of this past work looks at individuals with lower levels of educational quality. Because our cohort was highly educated and at the upper end of the reading spectrum, our results suggest that reading level is important to consider even for more highly educated individuals. Therefore, reading level is a critical variable to consider when interpreting verbally mediated neuropsychological measures for individuals across the educational spectrum.

Neurobiological and cognitive theories implicate deficits in executive function (EF) as a core facet of both depressive disorders and attention-deficit/hyperactivity disorder (ADHD), but empirical investigations inconsistently support this conclusion. Despite recognition of the likely bi-directional relationship of EF deficits to depression and ADHD, respectively, the extent to which comorbid depression might impact EF in adults remains unclear, considering more of the literature has examined children and adolescents. This study examined performance differences on EF measures in clinically-referred adults diagnosed with ADHD or a non-ADHD primary psychopathological condition in the presence/absence of comorbid depression.

This cross-sectional study included data from 404 adults referred for neuropsychological evaluation at a Midwestern academic medical center. In total, 343 met DSM-5 diagnostic criteria for ADHD (ADHD-all group:164 Predominantly Inattentive presentation [ADHD-I] and 179 Combined presentation [ADHD-C]) and 61 met criteria for a non-ADHD primary psychopathological condition (psychopathology group: 31 mood disorder, 17 anxiety disorder, and 13 posttraumatic stress disorder) when assessed via semi-structured clinical interview. All patients completed the Beck Depression Inventory-Second Edition (BDI-II) and five EF tests: Letter Fluency, Trail Making Test-Part B (Trails-B), Stroop Color and Word Test Color-Word trial (SCWT CW); and WAIS-IV Working Memory Index (WMI). Oneway MANOVAs assessed for significant EF differences between groups with high (BDI-II greater than or equal to 20) or low (BDI-II less than or equal to 19) depressive symptoms.

When group diagnosis (ADHD-all vs. psychopathology) was examined in the context of high or low depression, a significant difference in EF performance emerged between groups, F(12, 1042.72)=2.44, p<.01, Wilk's A=.93, partial n2=.02, with univariate analyses indicating a significant difference in FAS-T between at least two of the groups (F(3, 397)=3.92 , p< .01, partial n2=.03). Tukey's HSD Test for multiple comparisons found that the mean value of FAS-T was significantly different between the ADHD-high depression and ADHD-low depression groups (p=.046 , 95% CI = [5.81, -.04]) as well as between the ADHD-low depression and psychopathology-high depression groups (p=.05, 95% CI = [-8.89, .00]). A one-way MANOVA examining differences between groups when distinguishing ADHD by subtype revealed a statistically significant difference in EF performance between groups, F(20, 1301)=1.85, p<.05, Wilk's A=.91, partial n2=.02, with univariate analyses indicating a statistically significant difference in FAS-T between at least two of the groups (F(5, 395) = 2.39 , p<.05, partial n2 = .03). However, Tukey's HSD Test for multiple comparisons found that the mean value of FAS-T was not significantly different between any of the groups.

Overall, results indicate that clinically-referred patients with ADHD perform comparably on tests of EF regardless of the presence or absence of comorbid depression. These findings have implications for conceptualizing EF weaknesses in neuropsychological profiles for individuals with ADHD and suggest examining factors beyond comorbid depression.

Using a humanized APOE3/4 (Alzheimer’s disease genetic risk allele) mouse model we investigated the potential modulating effects of exercise on systemic risk factors and the ability of this mouse model to translate to active or sedentary, midlife, human participants. We present preliminary results of an ongoing, translational pilot study.

26 Midlife individuals, ages 40-65, were recruited from the community and dichotomized into active or sedentary groups following health screening and cognitive assessment. Blood samples were drawn from human participants for lipid assessment and other general health measures as well as peripheral growth factors concentrations (VEGF, BDNF and FGF21). Traditional, transgenic mouse models have helped the scientific community to understand biological mechanisms of Alzheimer’s disease (AD), but they do not develop significant neuronal loss, a hallmark of AD pathology. The MODEL-AD consortium has created a new “humanized” APOE4 model that has the human APOE4 allelic sequence in place of the mouse APOE gene; the model has shown known human phenotypes including deficits in cholesterol trafficking, amyloid clearance and BBB integrity. Of upmost importance, this model does not develop a full AD phenotype indicating that additional genetics and/or environmental factors are required as would be seen in human populations. We used males and females of this model to complete identical sedentary and active measures of each APOE genotype.

Lipid and general health marker assessment between mouse and human were similar and reproduced published literature. In both humans and mice we saw increased total cholesterol and HDL in active females and decreased total cholesterol and HDL in active males. We also saw similar relationships between APOE genotype, sex, and activity with regards to triglycerides. Although total cholesterol, HDL and LDL measures are the primary lipids needed to confirm or deny translation, other lipid measurements were not equivalent between the two models. Growth factor assessment in both species are also similar and reproduce published literature with regards to VEGF and BDNF as we see trending elevated levels in the active group. Less published on is the finding seen between active females and these elevated growth factors levels; our results indicates that although elevated as a result of exercise, this increase may be more prominent in females.

Based on the results found here we conclude that The Jackson Laboratory’s humanized APOE3/4 mouse model is a translatable model of vascular dysfunction, dementia and Alzheimer’s disease. We also conclude that exercise modulates these aspects by growth factor activation and increases resulting in downstream effects that reduce peripheral vascular risk factors and therefore reduce the risk of Alzheimer’s disease as a result of neuroinflammation. Complete, APOE genotype results from human participants are still ongoing. Descriptive analysis is limited by human samples size.

Women have a greater lifetime risk of developing Alzheimer’s disease (AD) dementia than men, a sex/gender disparity that cannot be explained by female longevity alone. There is substantial evidence for sex differences in the effects of APOE £4 on risk for AD. While APOE e4 increases AD risk in both sexes, women who carry APOE e4 are disproportionately vulnerable to cognitive impairment and AD compared to their counterpart men. In contrast to APOE e4, APOE £2 is associated with slower cognitive decline and a lower risk of AD. Although a less robust literature, APOE e2 may also have sex-specific effects. Because APOE e2 is the rarest major APOE allele, well-powered studies are needed to examine sex-specific effects. The objective of the present study was to examine sex-specific associations of APOE e2 carriage with longitudinal cognitive decline in a large cohort of clinically unimpaired adults.

We used observational data from two sources: the National Alzheimer’s Coordinating Center (NACC) and the Rush Alzheimer’s Disease Center (ROS/MAP/MARS) studies. We included data from clinically unimpaired adults who were >50 years old at baseline who self-identified as non-Hispanic White (NHW) or non-Hispanic Black (NHB). Participants were categorized as APOE £2, £4, or £3/e3 carriers. APOE e2/e4 carriers were excluded. The same battery of neuropsychological tests was used to assess global cognition in participants from both data sources. Linear mixed models examined interactive associations of genotype (£2 or £4 vs. £3/£3), sex, and time on longitudinal cognition in NHW and NHB participants separately. Analyses were first performed in a pooled sample of NACC and ROS/MAP/MARS participants and if significant they were repeated separately in each data source.

Across both data sources, 9,766 NHW (mean (SD) age=73.0(9.00) years, mean (SD) education=16.3(2.83) years, n(%) women=6,344(65.0)) and 2,010 NHB participants (mean(SD) age=71.3(7.59) years, mean(SD) education=14.9(3.10) years, n(%) women=1,583(78.8)) met inclusion criteria. Sex modified the association between APOE £2 and cognitive decline in NHW (ß=0.097, 95% CI: 0.023-0.172, pint=.01) but not NHB participants (ß=-0.011, 95% CI: -0.153-0.131, pint=.9). In sex-stratified analyses of NHW participants, APOE £2 (vs. £3/£3) carriage was associated with attenuated cognitive decline in men (ß=0.096, 95% CI: 0.037-0.155, p=.001), but not women (ß=-0.001, 95% CI: -0.044-0.043, p=.97). In analyses comparing men and women APOE £2 carriers, men exhibited slower cognitive decline than women (ß=0.120, 95% CI: 0.051-0.190, p=.001). Analyses performed separately in NACC and ROS/MAP revealed the same pattern of male-specific APOE £2 protection in NHW participants in both data sources.

In light of the longstanding view that APOE £2 protects against AD and dementia, our results provide evidence that APOE £2 is associated with attenuated cognitive decline in men but not women among NHW adults. This male-specific protection may contribute to sex differences in AD-related cognitive decline. Our findings have important implications for understanding the biological drivers of sex differences in AD risk, which is crucial for developing sex-specific strategies to prevent and treat AD dementia.

To examine patterns of cognitive function among a clinical sample of patients seeking treatment for Post-Acute Sequelae of COVID-19 (PASC).

One hundred nineteen patients each completed a baseline neuropsychological evaluation, including clinical diagnostic interview, cognitive assessments, and a comprehensive battery of self-report questionnaires. Patients had a mean age of 50 years (range:18 to 74, SD=10.1) and a mean of 15.5 years (SD=2.54) of formal education. Patients were primarily female (74%) and of White/Caucasian race (75%). Hierarchical agglomerative clustering was used to partition the data into groups based on cognitive performance. Euclidean distance was used as the similarity measure for the continuous variables and within-cluster variance was minimized using Ward’s method. The optimal number of clusters was determined empirically by fitting models with 1 to 15 clusters, with the best number of clusters selected using the silhouette index. All analyses were conducted using the NbClust package, an R package for determining the relevant number of clusters in a data set.

Clustering yielded two distinct clusters of cognitive performance. Group 1 (n=57) performed worse than Group 2 (n=62) on most cognitive variables (including a brief cognitive screener and tests of attention/working memory, executive function, processing speed, learning and delayed recall). Of note, there were no significant differences between groups on an infection severity scale, hospitalizations/ICU admissions, initial or current COVID-19 symptoms, or prior comorbidities. Groups did not differ in age or gender, but Group 1 had a lower education level than Group 2 (M=14.7, SD=2.45 vs. M=16.2, SD=2.42; p=.001). Group 1 also had significantly more minorities than Group 2 (40% vs. 8%; p<.001). No other demographic differences (income, living arrangement, or marital status) were observed. In comparison to Group 2 patients, Group 1 patients self-reported significantly higher levels of anxiety and depression and functional impairment (Functional Activities Questionnaire: M=11.3, SD=8.33 vs. M=7.65, SD=7.97), perceived stress (Perceived Stress Scale: M=24.7, SD=7.90 vs. M=20.3, SD=7.89), insomnia (Insomnia Severity Index: M=16.0, SD=6.50 vs. M=13.1, SD=6.76), and subjective cognitive functioning (Cognitive Failures Questionnaire: M=58.8, SD=16.9 vs. M=50.3, SD=18.6; p’s<.05).

Findings indicate two predominant subtypes of patients seeking treatment for PASC, with one group presenting as more cognitively impaired and reporting greater levels of anxiety, depression, insomnia, perceived stress, functional limitations, and subjective cognitive impairment. Future directions include follow-up assessments with these patients to determine cognitive trajectories over time and tailoring treatment adjuncts to address mood symptoms, insomnia, functional ability, and lifestyle variables. Understanding mechanisms of differences in cognitive and affective symptoms is needed in future work. Limitations to the study were that patients were referred for evaluation based on the complaint of “brain fog” and the sample was a homogenous, highly educated, younger group of individuals who experienced generally mild COVID-19 course.

Associative memory is impacted early in Alzheimer’s disease (AD). Poorer performance on associative memory tests has been related to greater amyloid and regional tau burden in preclinical AD. Our group previously examined the association of brain pathology and performance on the Free and Cued Selective Reminding Test (FCSRT) in Autosomal Dominant Alzheimer’s Disease (ADAD), finding that associative memory summary scores distinguished non-demented mutation carriers from non-carriers several years before clinical onset of cognitive impairment. In the current study, we examined whether FCSRT learning slopes were associated with brain pathology in a sample of ADAD carriers and non-carriers.

There were 119 participants including 57 non-demented carriers of the Colombian kindred with the Presenilin1 E280A mutation and 62 non-carrier family members (mean age= 36.3, 60% female). Participants were administered the Mini-Mental State Examination (MMSE), a measure of global cognitive status, and the FCSRT, which consists of three trials in which participants are asked to freely recall the same list of 16 items. It is a well-established measure known to be sensitive to early changes in AD. A subsample of 69 participants (32 carriers and 37 non-carriers) underwent positron emission tomography (PET) to measure in vivo cortical amyloid-beta (Pittsburgh compound B, PiB), and regional tau (Flortaucipir, FTP) burden in entorhinal and precuneus regions, which are among the earliest sites of tau accumulation in this ADAD population. Mann Whitney U tests, Spearman correlations, and chi-square tests were used to examine group differences and relations among variables of interest. Learning slope was calculated by subtracting the number of items freely recalled in FCSRT Trial 1 from the number of items freely recalled in Trial 3.

Compared to non-carriers, carriers had greater cortical amyloid-ß and regional tau burden, lower MMSE scores (mean [SD]: carriers= 27.5 [2.7]; non-carriers= 28.8 [1.0]), and lower scores on total immediate/ delayed free/ cued recall scores on the FCSRT (all p<.01). The groups did not differ on age, sex, or education level (all p> 0.05). In the whole sample and in carriers only, we found that higher MMSE scores were associated with higher learning slope, meaning faster learning (whole group p= 0.25, p= 0.006; carriers p= 0.30, p=0.029). In the whole sample, we found that lower learning slope was associated with higher levels of amyloid (p=-.34, p=.006) and tau in the left, right, and bilateral precuneus region (p=-.43, p<.001; p=-.46, p<.001; p=-.45, p<.001). In carriers only, lower learning slope was associated with higher tau burden in the left, right, and bilateral precuneus specifically (p=-.43, p=.017; p=-.48, p=.008; p=-.46, p=.010, respectively). No significant associations were found in non-carriers.

These findings suggest that learning curves on an associative memory test may be sensitive to preclinical pathological changes in AD, specifically within the precuneus, a brain region known to be involved in cue reactivity, episodic memory retrieval, and mental imagery strategies. Future studies with larger samples are warranted to further examine associations between the FCSRT learning curves and regional tau accumulation in individuals with ADAD.

The COVID-19 pandemic significantly disrupted schools and learning formats. Children with epilepsy are at-risk for generalized academic difficulties. We investigated the potential impact of COVID-19 on learning in those with epilepsy by comparing achievement on well-established academic measures among school-age children with epilepsy referred prior to the COVID-19 pandemic and those referred during the COVID-19 pandemic.

This study included 466 children [52% male, predominately White (76%), MAge=10.75 years] enrolled in the Pediatric Epilepsy Research Consortium Epilepsy (PERC) Surgery database project who were referred for surgery and seen for neuropsychological testing. Patients were divided into two groups based on a proxy measure of pandemic timing completed by PERC research staff at each site (i.e., “were there any changes to typical in-person administration [of the evaluation] due to COVID?”). 31% of the sample (N = 144) were identified as having testing during the pandemic (i.e., “yes” response), while 69% were identified as having testing done pre-pandemic (i.e., “no” response). Of the 31% who answered yes, 99% of administration changes pertained to in-person testing or other changes, with 1% indicating remote testing. Academic achievement was assessed by performance measures (i.e., word reading, reading comprehension, spelling, math calculations, and math word problems) across several different tests. T-tests compared the two groups on each academic domain. Subsequent analyses examined potential differences in academic achievement among age cohorts that approximately matched grade level [i.e., grade school (ages 5-10), middle school (ages 11-14), and high school (ages 15-18)].

No significant differences were found between children who underwent an evaluation before the pandemic compared to those assessed during the pandemic based on age norms across academic achievement subtests (all p’s > .34). Similarly, there were no significant differences among age cohorts. The average performance for each age cohort generally fell in the low average range across academic skills. Performance inconsistently varied between age cohorts. The youngest cohort (ages 5-10) scored lower than the other cohorts for sight-word reading, whereas this cohort scored higher than the middle cohort (ages 11-14) for math word problems and reading comprehension. There were no significant differences between the two pandemic groups on demographic variables, intellectual functioning, or epilepsy variables (i.e., age of onset, number of seizure medications, seizure frequency).

Academic functioning was generally equivalent between children with epilepsy who underwent academic testing as part of a pre-surgical evaluation prior to the pandemic compared to those who received testing during the pandemic. Additionally, academic functioning did not significantly differ between age cohorts. Children with epilepsy may have entered the pandemic with effective academic supports and/or were accustomed to school disruptions given their seizure history. Replication is needed as findings are based on a proxy measure of pandemic timing and the extent to which children experienced in-person, remote, and hybrid learning is unknown. Children tested a year into the pandemic, after receiving instruction through varying educational methods, may score differently than those tested earlier. Future research can address these gaps. Although it is encouraging that academic functioning was not disproportionately impacted during the pandemic in this sample, children with epilepsy are at-risk for generalized academic difficulties and continued monitoring of academic functioning is necessary.

COVID-19 caused a worldwide restructuring of daily life, necessitating a sharp increase in social distancing, telecommunication, and adherence to rapidly changing public health recommendations. Coping, a response to stressors, is a protective mechanism to increase resiliency against uncertainty and decreased social connectedness. This disruption of daily life has prompted unanticipated and unique research opportunities and allowed researchers to consider whether individuals' primary coping style with the pandemic is associated with cognition. Previous research has found that problem coping, or action-oriented approaches to a stressor, is the most adaptive coping strategy. Emotion-based coping, like venting or humor, varies and depends on the stressor. Avoidant coping, like denial or ignoring the stressor, is generally considered maladaptive (Carver, 1977), which may lead to increased psychosocial disturbance. Executive functioning, responsible for planning, organizing, inhibition, and self-management are theorized to be most impacted by the social and psychological effects of COVID-19 (Pollizi et al., 2021). While some research has examined this question in working parent and older adult populations, we seek to understand this relationship in emerging adults, whose frontal lobes, responsible for executive functioning, are still developing. The present study seeks to examine the association between coping with the COVID-19 pandemic and executive functioning.

College students (N=440; M=19.30 years old, SD=1.42, 76% female) across seven US universities completed self-report questionnaires on SONA, which included Barkley's Deficits in Executive Functioning, Short Form (BDEFS-SF; Barkley, 2011) and the Brief Coping Orientation to Problems Experienced Inventory adapted for coping with the COVID-19 pandemic (Brief COPE; Carver 1989). Items on the BDEFS-SF were summed to create a global executive functioning score. Items on the Brief COPE were combined to create three factors: emotional,, avoidant,, and problem-focused (Dias et al., 2011).

Stepwise linear regression was used to assess whether coping style predicted executive functioning. Results indicate that the use of emotional coping (ß =0.19, p< .001) and avoidant coping (ß =0.33, p< .001) predicted higher scores on the BDEFS (greater deficits in executive functioning). Additionally, the use of problem coping (ß =-0.27, p< .001) predicted lower BDEFS scores (better executive functioning), with this overall model explaining 16.37% of the variance.

Results from this study confirm that COVID-19 coping styles are associated with decreased executive functioning. Specifically, emotional coping and avoidant coping predicted decreased executive functioning, which has been supported in non-pandemic samples. The use of problem-focused coping predicted increased executive functioning, indicating that this may be a protective form of coping with the pandemic. Because tasks necessary for daily life, such as planning, organizing, and judgment, rely on executive functioning, maladaptive coping with COVID-19 may impede college students' daily functioning necessary for successful engagement in schoolwork, emotion regulation, and activities of daily living. This research begins to address the gap in knowledge regarding the relationship between coping with the COVID-19 pandemic and executive functioning. This knowledge can be used in future crises in order to promote the use of problem-focused coping and mitigate the self-observed deficits in executive functioning demonstrated in this population.

The Biber Figure Learning Test (BFLT) is a serial figure learning assessment previously been shown to be sensitive to various biomarkers of the aging brain. BFLT is an extensive assessment requiring about 30 minutes for administration. In this study, we investigated BFLT’s associations with subjective cognitive decline (SCD), an early marker for preclinical Alzheimer’s Disease (AD), and examined whether alternative BFLT indices could be utilized to considerably shorten the length of assessment without decreasing its sensitivity to SCD.

Participants were 50 cognitively normal older adults (8% Hispanic, 92% Non-Hispanic; 78% White, 16% Black; 64% female; mean age =72.7 (SD =6.2); mean education =17.05 (SD =2.09)). SCD was measured using a 20-item age-anchored dichotomous questionnaire that assessed complaints of cognitive functioning, and the BFLT was administered in full. Pearson correlations were conducted between SCD and BFLT scores including: Trial 1 Learning (T1), Trials 1 to 2 Total Learning (T1T2), Trials 1 to 3 Total Learning (T1T3), Trials 1 to 5 Total Learning (Total Learning), Immediate Recall, Delayed Recall, Proactive Interference (Trial B – Trial 1), Retroactive Interference (Immediate Recall – Trial 5), and Total Discrimination (calculated as [Recognition Total Correct + 0.5]/16) − ([Total False Alarms + 0.5]/31]). A Fishers Exact Test was utilized to compare the correlational strength between SCD and each of the BFLT scores. Lastly, demographically adjusted (age, gender, and education) regression models were conducted to examine SCD as an individual predictor for the various BFLT scores.

SCD was negatively associated with BFLT T1 (r =-0.406, p =0.003), T1T2 (r =-0.331, p =0.019), T1T3 (r =-0.323, p =0.022), Total Learning (r =-0.283, p =0.046), Immediate Recall (r =-0.322, p =0.023), Delayed Recall (r =-0.318, p =0.025), and Retroactive Interference (r =-0.388, p =0.005) and positively associated with Proactive Interference (r =0.308, p =0.029). There was no significant difference in correlational strength between any of these BFLT scores and SCD. Adjusting for demographics, SCD predicted Immediate Recall (B =-0.273, p =0.029), Total Learning (B =- 0.253, p =0.040), T1 (B =-0.412, p =0.002), T1T2 (B =-0.326, p =0.010), T1T3 (B =-0.299, p =0.017), Proactive Interference (B =0.292, p =0.050), and Retroactive Interference (B =- 0.330, p =0.025).

Eight of the nine assessed BFLT scores were strongly correlated with age-anchored SCD and age-anchored SCD predicted seven of the nine assessed BFLT indices when adjusted for demographics. Although additional work is needed, these findings suggest SCD’s sensitivity to changes in visuospatial learning and memory, supporting its use as an early marker for preclinical AD. Likewise, our results suggest that an abbreviated version of the BFLT could be utilized that shortens testing time and reduces participant fatigue without a decrease in clinical relevance. Through ongoing longitudinal work, we hope to further disentangle the relationship between SCD and visuospatial learning and memory as measured through the BFTL and to examine how associations between SCD and the BFLT assessment change over time.

The Dunning-Krueger effect is a cognitive bias where individuals tend to overestimate their abilities in areas where they are less competent. The Cordoba Naming Test (CNT) is a 30-item confrontation naming task. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the NASA Task Load Index (NASA-TLX). Researchers reported that workload ratings on the NASA-TLX increased with increased task demands on a cognitive task. Anxiety is known as an emotion that can make an individual more susceptible to develop a mental health condition. We examine if the Dunning-Krueger effect occurs in a Mexican population with and without current symptoms of anxiety and possible factors driving individuals to overestimate their abilities on the CNT. We predicted the abnormal symptoms of anxiety (ASA) group would report better CNT performance, report higher perceived workloads on the CNT, and underperform on the CNT compared to the normal symptoms of anxiety (NSA) group. We also predicted the low-performance group would report better CNT performance, report higher perceived workloads on the CNT, and underperform on the CNT compared to the high-performance group.

The sample consisted of 192 Mexican participants with NSA (79 low-performance & 113 high-performance) and 74 Mexican participants with ASA (44 low-performance & 30 high-performance). Participants completed the CNT, NASA-TLX, and the Hospital Anxiety and Depression Scale (HADS) in Spanish. The NASA-TLX was used to evaluate perceived workloads after the completion of the CNT. Meanwhile, the HADS was used to create our anxiety groups. Finally, CNT raw scores were converted into T-scores, which then were averaged to create the following two groups: low-performance (CNT T-Score <50) and high-performance (CNT T-Score 50+). A series of 2x2 ANCOVAs, controlling for gender were used to evaluate CNT performance and perceived workloads.

We found a significant interaction where the low-performance ASA and the high-performance NSA groups demonstrated better CNT performance and reported higher perceived workloads (i.e., performance, temporal demand) on the CNT compared to their respective counterparts (i.e., low-performance NSA & high-performance ASA groups), p's<.05, ηp's2=.02. We found a main effect where the high-performance group outperformed the low-performance group on the CNT and reported lower perceived workloads on the CNT, p's<.05, ηp's2 =.04-.46.

The Dunning-Krueger effect did not occur in our sample. Participants that demonstrated better CNT performance also reported higher perceived workloads regardless of their current symptoms of anxiety. A possible explanation can be our sample's cultural norms of what would be considered as abnormal symptoms of anxiety, is a normal part of life, decreasing the possibilities to experience self-efficacy distoritions. Future studies should investigate whether the Dunning-Kruger effect may be influencing other aspects of cognitive functioning subjectively in Mexicans residing in Mexico and the United States with and without current symptoms of anxiety.

To determine the effects of the non-classic psychedelic, ibogaine, on cognitive functioning. Ibogaine is an indole alkaloid derived from the Tabernanthe Iboga plant family, indigenous to Africa, and traditionally used in spiritual and healing ceremonies. Ibogaine has primarily been studied with respect to its clinical efficacy in reducing substance addiction. There are, however, indications that it also may enhance recovery from traumatic experiences. Ibogaine is a Schedule 1 substance in the USA.

Participants were U.S. Special Operations Veterans who had independently and voluntarily referred themselves for an ibogaine retreat at a specialized clinic outside the USA prior to learning about this observational study. After meeting rigorous screening requirements, 30 participants were enrolled, all endorsing histories of combat and repeated blast exposure, as well as traumatic brain injury. Participants were seen in person pre-treatment, post-treatment, and one-month post-treatment for neuropsychological testing, neuroimaging, and collection of clinical outcome measures. All 30 participants were seen pre- and post-treatment, of whom 27 were also able to return one-month post-treatment.

The neuropsychological battery included the the Hopkins Verbal Learning Test (HVLT), the Brief Visuospatial Memory Test - Revised (BVMT-R), the Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) Working Memory Index (Digit Span and Arithmetic) and Processing Speed Index (Symbol Search and Coding), and the Delis-Kaplan Executive Function System (D-KEFS) tests of Verbal Fluency (VF), Trail Making (TMT), Color Word (CW), and Tower Test (TT). For repeated measures, alternate forms were used whenever possible.

Repeated-measures ANOVA revealed significant effects of time, with post-treatment improvements across multiple measures including processing speed (WAIS-IV PSI; F(2,25) = 26.957, p < .001), executive functions (CW Conditions 3 and 4: F(1.445,25) = 11.383, p < .001 and F(1.381,25) = 7.687, p = .004, respectively), verbal fluency (VF Condition 3 correct and accuracy: F(2,25) = 6.419, p = .003 and F(2,25) = 153.076, p < .001, respectively), and verbal learning (HVLT Total Recall (alternate forms used at each time point): F(1.563,23) = 6.958, p = .004). Score progression graphs are presented. Performance on all other cognitive measures did not significantly change following treatment.

To our knowledge, this is the first prospective study examining neuropsychological test performance following ibogaine use at post-treatment and one-month post-treatment time points. Our results indicated that several cognitive domains improved either post-treatment or one-month post-ibogaine treatment, suggesting ibogaine’s therapeutic potential for cognition in the context of traumatic brain injury and mood disorders. Potential explanations include neuroplastic changes, reduction of PTSD and mood-related effects on cognitive functioning, and practice effects. While we found no evidence of negative cognitive consequences for up to one-month post-single-ibogaine treatment, further study of this substance is necessary to clarify its clinical utility and safety parameters.

The prevalence of ADHD diagnoses more than doubled in VA settings between 2009 and 2016 (Hale et al., 2020). However, attentional difficulties are not exclusive to ADHD and can also be seen in non-neurodevelopmental disorders, including depression, anxiety, substance use, and PTSD (Marshall et al., 2018, Suhr et al., 2008). Further, patients can easily feign symptoms of ADHD with few available instruments for accurate detection (Robinson & Rogers, 2018). Given the significant symptom overlap and rising rates of reported ADHD among Veterans, accurate detection of feigned ADHD is essential.

This study examined the utility of the experimental Dissimulation ADHD scale (Ds-ADHD; Robinson & Rogers, 2018) on the MMPI-2, in detecting feigned ADHD presentation within a mixed sample of Veterans.

In this retrospective study, 173 Veterans (Mage = 36.18, SDage = 11.10, Medu = 14.01, SDedu = 2.11, 88% male, 81% White, and 17% Black) were referred for neuropsychological evaluation of ADHD that included the MMPI-2 and up to 10 PVTs. Participants were assigned to a credible group (n=146) if they passed all PVTs or a non-credible group (n=27) if they failed two or more PVTs. Group assignment was also clinically confirmed. The Ds-ADHD was used to differentiate groups who either had credible or non-credible performance on cognitive measures. Consistent with Robinson and Rogers’ study, “true” answers (i.e., erroneous stereotypes) were coded as 1 and “false” answers were coded as 2, creating a 10- to 20-point scale. Lower scores were associated with a higher likelihood of a feigned ADHD presentation.

Preliminary analyses revealed no significant group differences in age, education, race, or gender (ps > .05). An ANOVA indicated a significant difference between groups (F[1, 171] = 10.44, p = .001; Cohen’s d = .68) for Ds-ADHD raw scores; Veterans in the non-credible group reported more “erroneous stereotypes” of ADHD (M raw score = 13.33, SD = 2.20) than those in the credible group (M = 14.82, SD = 2.20). A ROC analysis indicated AUC of .691 (95% CI = .58 to .80). In addition, a cut score of <12 resulted in specificity of 91.8% and sensitivity of 18.5%, whereas a cut score of <13 resulted in specificity of 83.6% and sensitivity of 44.4%.

The Ds-ADHD scale demonstrated significant differences between credible and non-credible respondents in a real-world setting. Previously, this scale has primarily been studied within laboratory settings. Further, results indicate a cut score of <12 could be used in order to achieve adequate specificity (i.e., >90%), which were similar findings to a study examining SVT-based groups (Winiarski et al., 2023). These results differ slightly from prior research by Robinson and Rogers (2018), who indicated a cut score of <13 based on the initial simulation-based study. In similar clinical settings, where there are high rates of psychiatric comorbidity, a cut score of <12 may prove clinically useful. However, this cut-score was associated with low sensitivity within this mixed Veteran sample. Further research should focus on replicating findings within other clinical settings, including ones with larger non-credible samples.

Digitized cognitive assessment captures rich behavioral information that remains unmeasured using conventional methods. Data capture tools recently accessible only in specialized laboratories are now feasible at scale using off-the-shelf tablet devices. This study aims to share data from a digitized cognitive assessment embedded in an open-science research program collecting extensive neuroimaging, health, behavioral, neuropsychological, and psychiatric characterizations to advance translational cognitive neuroscience. In this research we present normative performance metrics from a digital version of the Trail Making Test.

The NKI-Rockland Sample (NKI-RS) has provided a model for openly-shared lifespan normative neuroimaging resources contributed by a community-ascertained sample (n=1,500, aged 6-85) and generating over 400 publications across diverse research areas. The next generation NKI-RS study (recruitment target= 600, aged 9-75) aims to enrich these resources for brain-behavioral research, normative reference, and biomarker discovery. One focus of innovation is the inclusion of digitized cognitive assessments (DCAs) utilizing an open-resource task development and data collection platform (Mindlogger, Child Mind Institute). We present preliminary data from a digitized version of the Trail Making Tests and report early descriptive metrics. The TMTs was administered via an iPad Pro using an Apple pen as part of a laboratory-based EEG procedure. The TMTs follows standard administration instructions, including a practice sample before each test condition. Error feedback is included in the task implementation such that an incorrect connection is marked with an “x” and the participant is directed to the last correct circle to continue. Feedback is automated within the task. Pixel-level spatial resolution and millisecond timing is captured across all drawing tasks. Task design, implementation, and preliminary performance metrics including speed, accuracy, and variability are reported.

Preliminary data include 12 participants from the NKI-RS2 study ranging in age from 11-75 years (M= 52.83, SD= 19.97); 67% female. Overall participants took longer to complete condition B (Mb = 51.71 secs) compared to condition A (Ma = 23.07 secs), p= 0.0005. Connections were made more slowly (Ma = 37.47 secs vs. Mb = 24.50 secs, p< 0.001) and connection speed was more variable (CVa = 0.90 vs. CVb = 1.22, p< 0.01) on condition B versus A. Connection speed decreased and speed variability increased with age (t[11 ]= -3.25, p= 0.05, t[11]= -3.63, p< 0.01, respectively). Time spent within circles (dwell time) was significantly greater in B versus A (t[11]= 6.81, p< 0.001). Number of errors were limited (MA = .89 and MB = 1.0, range 0-2 in both tests) with no difference between tests or effects of age (both ps >0.05).

These preliminary data from the NKI-RS2 normative neuroimaging study demonstrate that a digitized version of a classic neuropsychological test is feasible across a diverse range of community participants, and replicates known age effects. The advantages of growing access to these DCA tools and the shared data resources they will produce has the potential to revolutionize neuropsychological research and clinical practice.

Neuroimaging is commonly used in medicine to identify neuropathology and is widely considered to be a reliable and valid diagnostic modality. Personality testing is commonly used to identify psychopathology but is generally perceived to have less clinical efficacy than neuroimaging. The purpose of the current study was to compare the clinical efficacy of personality tests to neuroimaging using meta-analysis.

Multiple databases were searched for original research utilizing either personality tests or neuroimaging. The search interval covered articles published within the last 10 years. Studies were selected based on the criteria of having a clinical group and a healthy control sample with a reported diagnostic outcome. For this meta-analysis, neuroimaging studies focusing on diagnostic utility for Alzheimer’s dementia were included. Personality testing studies were included if they broadly reported a clinical outcome, due to fewer studies in this area. Studies were coded using a complex multi-comparison, outcome, and subgroup schema, and were analyzed under random-effects modeling.

Out of the 240 studies identified for the personality domain, 13 were selected for the meta-analysis. Out of 6522 studies identified for the neuroimaging domain, 21 studies were selected for the meta-analysis. Results indicated a significant difference between the neuroimaging and personality testing effect sizes. Specifically, neuroimaging [Hedge’s g = -1.623, 95% CI = -1.973 to -1.273, p<.001] yielded a greater effect size in comparison to the personality tests effect size [Hedge’s g = -0.658, 95% CI = -0.751 to -0.565, p<.001]. The effect size for clinical utility of neuroimaging was close to double that of the effect for personality tests diagnostic utility.

Findings from this meta-analysis showed a significant difference in the effect sizes obtained from neuroimaging studies compared to the studies of personality tests. While both neuroimaging and personality testing demonstrated meaningful clinical utility, neuroimaging studied had a larger effect size.