Objectives: Past research suggests that youth with sex chromosome aneuploidies (SCAs) present with verbal fluency deficits. However, most studies have focused on sex chromosome trisomies. Far less is known about sex chromosome tetrasomies and pentasomies. Thus, the current research sought to characterize verbal fluency performance among youth with sex chromosome trisomies, tetrasomies, and pentasomies by contrasting how performance varies as a function of extra X number and X versus Y status. Methods: Participants included 79 youth with SCAs and 42 typically developing controls matched on age, maternal education, and racial/ethnic background. Participants completed the phonemic and semantic conditions of a verbal fluency task and an abbreviated intelligence test. Results: Both supernumerary X and Y chromosomes were associated with verbal fluency deficits relative to controls. These impairments increased as a function of the number of extra X chromosomes, and the pattern of impairments on phonemic and semantic fluency differed for those with a supernumerary X versus Y chromosome. Whereas one supernumerary Y chromosome was associated with similar performance across fluency conditions, one supernumerary X chromosome was associated with relatively stronger semantic than phonemic fluency skills. Conclusions: Verbal fluency skills in youth with supernumerary X and Y chromosomes are impaired relative to controls. However, the degree of impairment varies across groups and task condition. Further research into the cognitive underpinnings of verbal fluency in youth with SCAs may provide insights into their verbal fluency deficits and help guide future treatments. (JINS, 2018, 24, 917–927)

Objectives: Research indicates that symptoms following a concussion are related to cognitive dysfunction; however, less is known about how different types of symptoms may be related to cognitive outcomes or how specific domains of cognition are affected. The present study explored the relationship between specific types of symptoms and these various cognitive outcomes following a concussion. Methods: One-hundred twenty-two student-athletes with sports-related concussion were tested with a battery that included a symptom report measure and various cognitive tests. Symptoms factors were: Physical, Sleep, Cognitive, Affective and Headache. Participants were grouped into “symptom” and “no symptom” groups for each factor. Cognitive outcomes included both overall performance as well as impairment scores in which individuals were grouped into impaired and not impaired based on a cutoff of 2 or more tests at the impaired level (<80 in standard scores). These cognitive outcomes were examined for all the tests combined and then specifically for the memory tests and attention/processing speed tests. A Bonferroni correction was used, and the results were considered significant at a level of p<.008. Results: Headache symptoms were significantly (p<.008) associated with overall cognitive impairment as well as memory and attention/processing speed impairment. Sleep symptoms were related to memory impairments. Conclusions: The symptom specific relationships to cognitive outcomes demonstrated by our study can help guide treatment and accommodations for athletes following concussion. (JINS, 2018, 24, 1–9)

Objectives: Intraindividual variability increases with age, but the relative strength of association with cognitive domains is still unclear. The objective of this study was to examine the relation between cognitive domains and the shape and spread of response time (RT) distributions as indexed by intraindividual standard deviation (ISD), and ex-Gaussian parameters (μ, σ, τ). Methods: Healthy adults (40 young [aged 18–30 years], 40 young-old [aged 65–74 years], and 41 old-old [aged 75–85 years]) completed neuropsychological testing and a touch-screen attention task from which ISD and ex-Gaussian parameters were derived. The relation between RT performance and cognitive domains (memory, processing speed, executive functioning) was examined with structural equation modeling (SEM), and the predictive power of RT distribution indices over age was investigated with linear regression. Results:ISD, μ, and τ, but not σ, showed a linear increase with age group. An SEM showed that independent of age, τ was most strongly associated with executive functioning, while μ exhibited less critical associations. Linear regression indicated that μ and τ explained a significant portion of variance in processing speed and executive ability in addition to age group. Memory was more parsimoniously predicted by age, without any significant contribution of ex-Gaussian parameters. Conclusions: The findings suggest that exceptionally slow responses convey attention lapses through wavering of cognitive control, which strongly correspond to executive functioning tests. General slowing and extremely slow responses predicted processing speed and executive performance beyond age group, indicating that RT metrics are sensitive to differences in cognitive ability. (JINS, 2018, 24, 456–465)

Objectives: Naming assessment is a core component of neuropsychological evaluation, particularly in the surgical work up for patients with pharmacologically refractory epilepsy. Specifically, naming deficits are typically associated with left, but not right hemisphere epilepsy, thereby assisting with lateralization of seizure onset. We sought to determine whether bilingual (English as second language, ESL) and monolingual epilepsy patients with comparable education, intelligence, and objective vocabulary performance would perform similarly on standard naming measures, and whether ESL patients would demonstrate laterality effects in naming, similar to that observed in monolingual patients. Methods: Participants were 242 adults with epilepsy (186 native, 56 ESL) who underwent neuropsychological evaluation and obtained normal range or higher scores on the Wechsler Adult Intelligence Scale (R/III/IV) Vocabulary subtest (scaled score≥8). Groups were compared on demographic factors and language performances (i.e., Boston Naming Test, Auditory & Visual Naming Test, word reading, fluency). Results: Groups did not differ with respect to age, education, FSIQ, vocabulary, reading, or verbal fluency. However, ESL speakers earned poorer scores than native English speakers on all naming measures. Moreover, among ESL participants with unilateral epilepsy, a significant proportion of right hemisphere patients scored below cutoff for impairment. This contrasted with the more typical finding among native English speakers, whereby a significant proportion of left patients demonstrated naming impairment. Conclusions: These results underscore the complexity of verbal assessment in bilinguals, suggesting that naming performances by ESL individuals, even those considered proficient, with strong performances on other English verbal measures, cannot be interpreted by the same standards applied for native speakers. (JINS, 2018, 24, 1057–1063)

Objectives: The purpose of this exploratory study was to identify clinical predictors that could distinguish clients’ level of engagement in inpatient rehabilitation following stroke. Methods: This is a secondary analysis of pooled data from three randomized controlled trials that examined the effects of a behavioral intervention. The sample (n=208) consisted of clients with stroke who had cognitive deficits (Quick-EXIT≥3) and were admitted to inpatient rehabilitation facilities associated with a university medical center. Individuals with pre-morbid dementia, aphasia and mood disorders were excluded. The Pittsburgh Rehabilitation Participation Scale was used to measure engagement. Clinical predictors were measured using the Functional Independence Measure, National Institutes of Health Stroke Scale, Repeatable Battery for the Assessment of Neuropsychological Status, selected subtests of the Delis-Kaplan Executive Function System, Patient Health Questionnaire-9, and Chedoke McMaster Stroke Assessment. Simple logistic regression identified individual clinical predictors associated with engagement. Hierarchical logistic regression identified the strongest predictors of engagement. Results: Impairments in executive functions [mean D-KEFS, odds ratio (OR)=4.062; 95% confidence interval (CI)=.866, 19.051], impairments in visuospatial skills (RBANS Visuospatial Index Score, OR=3.940; 95% CI=1.317, 11.785), impairments in mood (Patient Health Questionnaire-9, OR=2.059, 95% CI=.953, 4.449), and male gender (OR=2.474; 95% CI=1.145, 5.374) predicted levels of engagement in inpatient rehabilitation after controlling for study intervention group, baseline stroke severity, and baseline disability. Conclusions: Executive functions, visuospatial skills, mood, and gender distinguished individuals with high or low engagement in inpatient rehabilitation following stroke. Further studies should examine additional factors that may influence engagement (therapist-client relationship, treatment expectancy). (JINS, 2018, 24, 572–583)

Objectives: A substantial body of research has documented age-related declines in cognitive abilities among adults over 60, yet there is much less known about changes in cognitive abilities during midlife. The goal was to examine longitudinal changes in multiple cognitive domains from early midlife through old age in a large national sample, the Midlife in the United States (MIDUS) study. Methods: The Brief Test of Adult Cognition by Telephone (BTACT) was administered on two occasions (MIDUS 2, MIDUS 3), an average of 9 years apart. At MIDUS 3, those with the cognitive assessment (N=2518) ranged in age from 42 to 92 years (M=64.30; SD=11.20) and had a mean education of 14.68 years (SD=2.63). The BTACT includes assessment of key aging-sensitive cognitive domains: immediate and delayed free recall, number series, category fluency, backward digit span, processing speed, and reaction time for attention switching and inhibitory control, which comprise two factors: episodic memory and executive functioning. Results: As predicted, all cognitive subtests and factors showed very small but significant declines over 9 years, with differences in the timing and extent of change. Processing speed showed the earliest and steepest decrements. Those with higher educational attainment scored better on all tests except reaction time. Men had better executive functioning and women performed better on episodic memory. Conclusions: Examining cognitive changes in midlife provides opportunities for early detection of cognitive impairments and possibilities for preventative interventions. (JINS, 2018, 24, 805–820)

Objectives: The present study investigated the independent and synergistic effects of amyloid beta (Aβ1-42) and phosphorylated tau (Ptau) pathologies on neuropsychological profiles and trajectories in cognitively normal older adults. Methods: Alzheimer’s Disease Neuroimaging Initiative participants identified as cognitively normal at baseline underwent longitudinal assessment (N=518; 0, 12, 24, 36 months), baseline lumbar puncture and follow-up cognitive exams. Cerebral spinal fluid (CSF) biomarker profiles (Aβ-Ptau-, Aβ+Ptau-, Aβ-Ptau+, Aβ+Ptau+) were compared on baseline profiles and trajectories for memory (Rey Auditory Verbal Learning Test), attention/executive function (Trail Making Test, A and B), language (Animal Fluency, Vegetable Fluency, Boston Naming Test) and processing speed (Digit Symbol) using multilevel models. Results: The Aβ+Ptau+ group exhibited significantly worse baseline performance on tests of memory and executive function relative to the Aβ-Ptau+ and Aβ-Ptau- groups. The Aβ+Ptau- group fell between the Aβ+Ptau+ participants and the Aβ-Ptau- and Aβ-Ptau+ groups on all three cognitive domains and exhibited worse baseline executive function. The Aβ-Ptau+ group performed worse than Aβ-Ptau- participants on processing speed. Over 36-month follow-up, the Aβ+Ptau+ group exhibited the greatest declines in memory and semantic fluency compared to all other groups. Conclusions: Cognitively normal older adults with both Aβ and Ptau pathology exhibited the weakest profile, marked by the worst memory decline compared to the other groups. Other subtle changes in this group included declines in executive function and semantic fluency. Those with Ptau pathology alone showed slowed processing speed, and those with Aβ pathology alone showed worse attention and executive function compared to biomarker negative participants. (JINS, 2018, 24, 1–10)

Objectives: Anosognosia for motor impairment is a complex syndrome that can manifest itself under different forms, guiding patients’ behavior and task decisions. However, current diagnostic tools tend to evaluate only more explicit aspects of anosognosia (asking the patients about their motor abilities) and fail to address more subtle features of awareness. We have developed a new assessment measure, the ECT (Errand Choice Test), where patients are asked to judge task difficulty rather than estimate their own impairment. Methods: We assessed awareness in a group of 73 unilateral left- and right-brain damaged (30 LBD and 43 RBD, respectively) patients by means of the VATAm, which explicitly requires them to evaluate their own motor abilities, and the ECT. A control group of 65 healthy volunteers was asked to perform the ECT under two conditions: Current condition (i.e., using both hands) and Simulated conditions (i.e., simulating hemiplegia). Results: A total of 27% of the patients showed different performance on the VATAm and ECT, 21% of the patients showing lack of awareness only on VATAm and 6% only on ECT. Moreover, despite the ECT identified a higher frequency of anosognosia after RBD (33.3%) than LBD (27.6%), this hemispheric asymmetry was not significant. Remarkably, anosognosic patients performed very similarly to controls in the “current condition”, suggesting that anosognosic patients’ ability to perceive the complexity of each task per se is not altered. Conclusion: Different methods may be able to tackle different aspects of awareness and the ECT proved to be able to detect less evident forms of awareness. (JINS, 2018, 24, 45–56)

Objectives: The aim of this study was to identify whether the three main primary progressive aphasia (PPA) variants would show differential profiles on measures of visuospatial cognition. We hypothesized that the logopenic variant would have the most difficulty across tasks requiring visuospatial and visual memory abilities. Methods: PPA patients (n=156), diagnosed using current criteria, and controls were tested on a battery of tests tapping different aspects of visuospatial cognition. We compared the groups on an overall visuospatial factor; construction, immediate recall, delayed recall, and executive functioning composites; and on individual tests. Cross-sectional and longitudinal comparisons were made, adjusted for disease severity, age, and education. Results: The logopenic variant had significantly lower scores on the visuospatial factor and the most impaired scores on all composites. The nonfluent variant had significant difficulty on all visuospatial composites except the delayed recall, which differentiated them from the logopenic variant. In contrast, the semantic variants performed poorly only on delayed recall of visual information. The logopenic and nonfluent variants showed decline in figure copying performance over time, whereas in the semantic variant, this skill was remarkably preserved. Conclusions: This extensive examination of performance on visuospatial tasks in the PPA variants solidifies some previous findings, for example, delayed recall of visual stimuli adds value in differential diagnosis between logopenic variant PPA and nonfluent variant PPA variants, and illuminates the possibility of common mechanisms that underlie both linguistic and non-linguistic deficits in the variants. Furthermore, this is the first study that has investigated visuospatial functioning over time in the PPA variants. (JINS, 2018, 24, 259–268)

Objectives: To examine academic performance in dystrophinopathy as a function of dystrophin gene mutation position as well as intellectual function, executive skills, socioeconomic status (SES), behavior, and physical ability. Methods: In a cross-sectional study, boys with dystrophinopathy (ages 5–17; n=50) completed tests of academics (Woodcock-Johnson-III: spelling, reading, calculation and total scores), executive functioning (selective attention/inhibitory control, set shifting, working memory, and processing speed), single word comprehension and nonverbal reasoning. Motor skills were assessed and parents provided demographic information and child behavioral assessments. Dystrophin gene mutation positions were dichotomized into groups (upstream versus downstream of exon 43, location of isoforms previously linked to intellectual impairment). Genetic mutation groups were compared on measures of academic achievement, and multiple regression analyses examined unique and joint contributions of executive skills, intelligence quotient (IQ), SES, motor abilities, behavior, and mutation positions to academic outcomes. Results: Academic performance was slightly, yet significantly, lower than IQ and varied as a function of dystrophin gene position, wherein boys possessing the downstream mutation exhibited greater impairment than boys with the upstream mutation. Digit span forward (indexing verbal span), but no other measure of executive function, contributed significant variance to total academic achievement, spelling and calculation. Conclusions: Weak academic performance is associated with dystrophinopathy and is more common in downstream mutations. A specific deficit in verbal span may underlie inefficiencies observed in children with dystrophinopathy and may drive deficits impacting academic abilities. (JINS, 2018, 24, 928–938)

Objectives: Adverse effects of heavy drinking on cognition have frequently been reported. In the present study, we systematically examined for the first time whether clinical neuropsychological assessments may be sensitive to alcohol abuse in elderly patients with suspected minor neurocognitive disorder. Methods: A total of 144 elderly with and without alcohol abuse (each group n=72; mean age 66.7 years) were selected from a patient pool of n=738 by applying propensity score matching (a statistical method allowing to match participants in experimental and control group by balancing various covariates to reduce selection bias). Accordingly, study groups were almost perfectly matched regarding age, education, gender, and Mini Mental State Examination score. Neuropsychological performance was measured using the CERAD (Consortium to Establish a Registry for Alzheimer’s Disease). Classification analyses (i.e., decision tree and boosted trees models) were conducted to examine whether CERAD variables or total score contributed to group classification. Results: Decision tree models disclosed that groups could be reliably classified based on the CERAD variables “Word List Discriminability” (tapping verbal recognition memory, 64% classification accuracy) and “Trail Making Test A” (measuring visuo-motor speed, 59% classification accuracy). Boosted tree analyses further indicated the sensitivity of “Word List Recall” (measuring free verbal recall) for discriminating elderly with versus without a history of alcohol abuse. Conclusions: This indicates that specific CERAD variables seem to be sensitive to alcohol-related cognitive dysfunctions in elderly patients with suspected minor neurocognitive disorder. (JINS, 2018, 24, 360–371)

Objectives: The Automated Neuropsychological Assessment Metrics 4 TBI-MIL (ANAM4) is a computerized cognitive test often used in post-concussion assessments with U.S. service members (SMs). However, existing evidence remains mixed regarding ANAM4’s ability to identify cognitive issues following mild traumatic brain injury (mTBI). Studies typically examine ANAM4 using standardized scores and/ or comparisons to a baseline. A more fine-grained approach involves examining inconsistency within an individual’s performance (i.e., intraindividual variability). Methods: Data from 237 healthy control SMs and 105 SMs within seven days of mTBI who took the ANAM4 were included in analyses. Using each individual’s raw scores on a simple reaction time (RT) subtest (SRT1) that is repeated at the end of the battery (SRT2), we calculated mean raw RT and the intraindividual standard deviation (ISD) of trial-by-trial RT. Analyses investigated differences between groups in mean RT, RT variability (i.e., ISD), and change in ISD from SRT1 and SRT2. Results: Using regression residuals to control for demographic variables, analysis of variance, and pairwise comparisons revealed the control group had faster mean RT and smaller ISD compared to the mTBI group. Furthermore, the mTBI group had a significant increase in ISD from SRT1 to SRT2, with effect sizes exceeding the minimum practical effect for comparisons of ISD in SRT2 and change in ISD from SRT1 to SRT2. Conclusions: While inconsistencies in performance are often viewed as test error, the results suggest intraindividual cognitive variability may be more sensitive than traditional metrics in detecting changes in cognitive function after mTBI. Additionally, the findings highlight the utility of the ANAM4’s repeating a RT subtest at two points in the same session for exploring within-subject differences in performance variability. (JINS, 2018, 24, 156–162)

Objectives: We sought to clarify the nature of self-reported cognitive function among healthy older adults by considering the short-term, within-person association (coupling) of subjective cognitive function with objective cognitive performance. We expected this within-person coupling to differ between persons as a function of self-perceived global cognitive decline and depression, anxiety, or neuroticism. Methods: This was an intensive measurement (short-term longitudinal) study of 29 older adult volunteers between the ages of 65 and 80 years without an existing diagnosis of dementia or mild cognitive impairment. Baseline assessment included neuropsychological testing and self-reported depression, anxiety, and neuroticism, as well as self- and informant-reported cognitive decline (relative to 10 years previously). Intensive within-person measurement occasions included subjective ratings of cognitive function paired with performance on a computerized working memory (n-back) task; each participant attended four or five assessments separated by intervals of at least one day. Statistical analysis was comprised of multilevel linear regression. Results: Comparison of models suggested that both neuroticism and self-rated cognitive decline explained unique variance in the within-person, across-occasion coupling of subjective cognitive function with objective working memory performance. Conclusions: Self-ratings of cognition may accurately reflect day-to-day variations in objective cognitive performance among older adults, especially for individuals lower in neuroticism and higher in self-reported cognitive decline. Clinicians should consider these individual differences when determining the validity of complaints about perceived cognitive declines in the context of otherwise healthy aging. (JINS, 2018, 24, 57–66)

Objectives: This study investigated the relationship between close proximity to detonated blast munitions and cognitive functioning in OEF/OIF/OND Veterans. Methods: A total of 333 participants completed a comprehensive evaluation that included assessment of neuropsychological functions, psychiatric diagnoses and history of military and non-military brain injury. Participants were assigned to a Close-Range Blast Exposure (CBE) or Non-Close-Range Blast Exposure (nonCBE) group based on whether they had reported being exposed to at least one blast within 10 meters. Results: Groups were compared on principal component scores representing the domains of memory, verbal fluency, and complex attention (empirically derived from a battery of standardized cognitive tests), after adjusting for age, education, PTSD diagnosis, sleep quality, substance abuse disorder, and pain. The CBE group showed poorer performance on the memory component. Rates of clinical impairment were significantly higher in the CBE group on select CVLT-II indices. Exploratory analyses examined the effects of concussion and multiple blasts on test performance and revealed that number of lifetime concussions did not contribute to memory performance. However, accumulating blast exposures at distances greater than 10 meters did contribute to poorer performance. Conclusions: Close proximity to detonated blast munitions may impact memory, and Veterans exposed to close-range blast are more likely to demonstrate clinically meaningful deficits. These findings were observed after statistically adjusting for comorbid factors. Results suggest that proximity to blast should be considered when assessing for memory deficits in returning Veterans. Comorbid psychiatric factors may not entirely account for cognitive difficulties. (JINS, 2018, 24, 466–475)

Objectives: The self-reference effect (SRE), enhanced memory for self-related information, has been studied in healthy young and older adults but has had little investigation in people with age-related memory disorders, such as amnestic mild cognitive impairment (aMCI). Self-referential encoding may help to improve episodic memory in aMCI. Additionally, self-referential processing has been shown to benefit recollection, the vivid re-experiencing of past events, a phenomenon that has been termed the self-reference recollection effect (SRRE; Conway & Dewhurst, 1995). Furthermore, it remains unclear whether the valence of stimuli influences the appearance of the SRE and SRRE. Methods: The current study investigated the SRE and SRRE for trait adjective words in 20 individuals with aMCI and 30 healthy older adult controls. Ninety trait adjective words were allocated to self-reference, semantic, or structural encoding conditions; memory was later tested using a recognition test. Results: While healthy older adults showed a SRE, individuals with aMCI did not benefit from self-referential encoding over and above that of semantic encoding (an effect of “deep encoding”). A similar pattern was apparent for the SRRE; healthy controls showed enhanced recollection for words encoded in the self-reference condition, while the aMCI group did not show specific benefit to recollection for self-referenced over semantically encoded items. No effects of valence were found. Conclusions: These results indicate that while memory for trait adjective words can be improved in aMCI with deep encoding strategies (whether self-reference or semantic), self-referencing does not provide an additional benefit. (JINS, 2018, 24, 821–832)

Objectives: Both depression and apathy, alone and in combination, have been shown to negatively affect cognition in patients with Parkinson’s disease (PD). However, the influence of specific symptom dimensions of depression and apathy on cognition is not well understood. The current study investigated the relationship between symptom dimensions of depression and apathy, based on factors identified in Kirsch-Darrow et al. (2011), and memory and executive function in PD. Methods: A sample of 138 non-demented individuals with PD (mean age=64.51±7.43 years) underwent neuropsychological testing and completed the Beck Depression Inventory, 2nd Edition, and Apathy Scale. Separate hierarchical regression models examined the relationship between symptom dimensions of depression and apathy (“pure” depressive symptoms, “pure” apathy, loss of interest/pleasure [anhedonia], and somatic symptoms) and three cognitive domain composites: immediate verbal memory, delayed verbal memory, and executive function. Results: After adjusting for general cognitive status and the influence of the other symptom dimensions, “pure” depressive symptoms were negatively associated with the delayed verbal memory composite (p<.034) and somatic symptoms were positively associated with the executive function composite (p<.026). No symptom dimensions were significantly related to the immediate verbal memory composite. Conclusions: Findings suggest that specific mood symptoms are associated with delayed verbal memory and executive function performance in non-demented patients with PD. Further research is needed to better understand possible mechanisms through which specific symptom dimensions of depression and apathy are associated with cognition in PD. (JINS, 2018, 24, 269–282)

Objectives: Anecdotal reports suggest that following traumatic brain injury (TBI) retrograde memories are initially impaired and recover in order of remoteness. However, there has been limited empirical research investigating whether a negative gradient in retrograde amnesia—relative preservation of remote over recent memory—exists during post-traumatic amnesia (PTA) compared with the acute phase post-emergence. This study used a repeated-measures design to examine the pattern of personal semantic (PS) memory performance during PTA and within two weeks of emergence to improve understanding of the nature of the memory deficit during PTA and its relationship with recovery. Methods: Twenty patients with moderate-severe TBI and 20 healthy controls (HCs) were administered the Personal Semantic Schedule of the Autobiographical Memory Interview. The TBI group was assessed once during PTA and post-emergence. Analysis of variance was used to compare the gradient across lifetime periods during PTA relative to post-emergence, and between groups. Results: PS memory was significantly lower during PTA than post-emergence from PTA, with no relative preservation of remote memories. The TBI group was still impaired relative to HCs following emergence from PTA. Lower overall PS memory scores during PTA were associated with increased days to emerge from PTA post-interview. Conclusions: These results suggest a global impairment in PS memory across lifetime periods particularly during PTA, but still present within 2 weeks of emergence from PTA. PS memory performance may be sensitive to the diffuse nature of TBI and may, therefore, function as a clinically valuable indicator of the likely time to emerge from PTA. (JINS, 2018, 24, 1064–1072)

Objectives: As the number of adolescents and young adults (AYAs) surviving congenital heart disease (CHD) grows, studies of long-term outcomes are needed. CHD research documents poor executive function (EF) and cerebellum (CB) abnormalities in children. We examined whether AYAs with CHD exhibit reduced EF and CB volumes. We hypothesized a double dissociation such that the posterior CB is related to EF while the anterior CB is related to motor function. We also investigated whether the CB contributes to EF above and beyond processing speed. Methods: Twenty-two AYAs with CHD and 22 matched healthy controls underwent magnetic resonance imaging and assessment of EF, processing speed, and motor function. Volumetric data were calculated using a cerebellar atlas (SUIT) developed for SPM. Group differences were compared with t tests, relationships were tested with Pearson’s correlations and Fisher’s r to z transformation, and hierarchical regression was used to test the CB’s unique contributions to EF. Results: CHD patients had reduced CB total, lobular, and white matter volume (d=.52–.99) and poorer EF (d=.79–1.01) compared to controls. Significant correlations between the posterior CB and EF (r=.29–.48) were identified but there were no relationships between the anterior CB and motor function nor EF. The posterior CB predicted EF above and beyond processing speed (ps<.001). Conclusions: This study identified a relationship between the posterior CB and EF, which appears to be particularly important for inhibitory processes and abstract reasoning. The unique CB contribution to EF above and beyond processing speed alone warrants further study. (JINS, 2018, 24, 939–948)

Objectives: There is mixed evidence regarding whether patients with obsessive-compulsive disorder (OCD) display substantial neurocognitive deficits. Several studies implicate poor motivation, comorbid disorders, or distraction due to obsessive thoughts as potential causes of secondary malperformance. The present study examined the impact of stereotype threat (i.e., confrontation with a negative stereotype may impair performance) on neuropsychological functioning in individuals with OCD. We hypothesized that a stereotype threat cue emphasizing neurocognitive deficits in OCD (as is often conveyed in disclosure and consent documents that inform patients about the purpose of a study) would compromise patients’ test performance relative to a control group who did not receive such cue. Methods: Fifty participants with either a verified or a likely diagnosis of OCD were recruited online and randomly assigned to either an experimental condition aimed to elicit stereotype threat or a control condition. Both groups underwent (objective) memory and attention (Go/NoGo task) assessments and completed questionnaires capturing psychopathology, cognitive complaints, and self-stigma. Results: As hypothesized, patients in the stereotype threat condition performed worse on the Go/NoGo task. Groups did not differ on any other measures. Conclusions: Stereotype threat negatively impacted neuropsychological performance on an attention task. The threat cue was perhaps too weak or the stereotype threat was already internalized by the patients and “saturated” at baseline so that no effect emerged on the other measures. Implications for clinical trials are discussed. (JINS, 2018, 24, 584–592)

Objectives: Human immunodeficiency virus (HIV) disproportionately affects Hispanics/Latinos in the United States, yet little is known about neurocognitive impairment (NCI) in this group. We compared the rates of NCI in large well-characterized samples of HIV-infected (HIV+) Latinos and (non-Latino) Whites, and examined HIV-associated NCI among subgroups of Latinos. Methods: Participants included English-speaking HIV+ adults assessed at six U.S. medical centers (194 Latinos, 600 Whites). For overall group, age: M=42.65 years, SD=8.93; 86% male; education: M=13.17, SD=2.73; 54% had acquired immunodeficiency syndrome. NCI was assessed with a comprehensive test battery with normative corrections for age, education and gender. Covariates examined included HIV-disease characteristics, comorbidities, and genetic ancestry. Results: Compared with Whites, Latinos had higher rates of global NCI (42% vs. 54%), and domain NCI in executive function, learning, recall, working memory, and processing speed. Latinos also fared worse than Whites on current and historical HIV-disease characteristics, and nadir CD4 partially mediated ethnic differences in NCI. Yet, Latinos continued to have more global NCI [odds ratio (OR)=1.59; 95% confidence interval (CI)=1.13–2.23; p<.01] after adjusting for significant covariates. Higher rates of global NCI were observed with Puerto Rican (n=60; 71%) versus Mexican (n=79, 44%) origin/descent; this disparity persisted in models adjusting for significant covariates (OR=2.40; CI=1.11–5.29; p=.03). Conclusions: HIV+ Latinos, especially of Puerto Rican (vs. Mexican) origin/descent had increased rates of NCI compared with Whites. Differences in rates of NCI were not completely explained by worse HIV-disease characteristics, neurocognitive comorbidities, or genetic ancestry. Future studies should explore culturally relevant psychosocial, biomedical, and genetic factors that might explain these disparities and inform the development of targeted interventions. (JINS, 2018, 24, 163–175)