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SuperAgers are adults over the age of 80 with superior episodic memory performance and at least average-for-age performance in non-episodic memory domains. This study further characterized the neuropsychological profile of SuperAgers compared to average-for-age episodic memory peers to determine potential cognitive mechanisms contributing to their superior episodic memory performance.
Retrospective analysis of neuropsychological test data from 56 SuperAgers and 23 similar-age peers with average episodic memory was conducted. Independent sample t-tests evaluated between-group differences in neuropsychological scores. Multiple linear regression determined the influence of non-episodic memory function on episodic memory scores across participants.
As a group, SuperAgers had better scores than their average memory peers on measures of attention, working memory, naming, and speeded set shifting. Scores on tests of processing speed, visuospatial function, verbal fluency, response inhibition, and abstract reasoning did not differ. On an individual level, there was variability among SuperAgers with regard to non-episodic memory performance, with some performing above average-for-age across cognitive domains while others performed in the average-for-age range on non-memory tests. Across all participants, attention and executive function scores explained 20.4% of the variance in episodic memory scores.
As a group, SuperAgers outperformed their average memory peers in multiple cognitive domains, however, there was considerable intragroup variability suggesting that SuperAgers’ episodic memory strength is not simply related to globally superior cognitive functioning. Attention and executive function performance explained approximately one-fifth of the variance in episodic memory and maybe areas to target with cognitive interventions.
Studies on psychiatric patients have shown that the presence of autistic traits affects the effectiveness of the treatment, decreasing the likelihood of positive clinical outcomes.
The aim of the present study is to investigate which are the areas of overlap between psychiatric symptoms and the traits of the autism spectrum using a bayesian approach.
A sample of 190 adult psychiatric patients, diagnosed with schizophrenia, bipolar disorder, major depression, and personality disorder participated in the study. The RAADS-R questionnaire was used to assess the presence of autistic traits. The severity of psychiatric symptoms was measured with the BPRS and PANSS scales, the perceived well-being and disability using the Whodas and Whoqol scales, the TOL and STROOP for the measurement of executive functions, the attentional matrices for visual-spatial attention, the Raven for general cognitive skills.
No difference emerged between the diagnoses regarding the presence of symptoms of the autism spectrum, which affects 64% of subjects. Logistic regression showed that the severity of symptoms measured as BPRS and PANSS predicted the probability of having autistic traits. Bayesian regression showed that specific autistic traits are indicative of executive functions deficits. Namely, motor impairment severity measured at RAADS is strongly predicted by rule violation with number of correct moves measured at TOL. The other executive functions seemed to be only moderately linked to autistic traits.
These results provide new information about the expression of comorbidity with autism in psychiatric patients.
Anorexia Nervosa (AN) is an eating disorder characterized by low body weight, fear of gaining weight and distorted perception of body. Patients have rigidity, repetition of thoughts, alterations in decision-making skills and poor ability to provide new solutions. Avoidant/Restrictive Food Intake Disorder (ARFID) is a new eating disorder characterized by the absence of distress about body shape or fear of weight gain. Studies on neurocognitive aspects are few and no effective treatments are known.
The aim of our study was to further investigate the executive functions’ domains in AN and ARFID children and adolescents, to provide possible distinct neurocognitive traits in these patients.
AN or ARFID patients (15 + 15; range 6-18 years), were assessed by neuropsychological tools, such as: Wechsler Intelligence Scale to measure I.Q. profile, NEPSY-II to explore attention and executive functions, Tower of London test to detect planning and problem solving abilities, the Bells Test to evaluate visual selective and focused attention, the Wisconsing Card Sorting Test (WCST) for assessment of flexibility and directing behaviors by achieving a goal and the Rey-Osterrieth complex figure test (ROCF) to assess visual-spatial abilities.
Patients with ARFID presented impairments in several executive functions domains, with difficulties in the impulse inhibition, in the sustained attention and in visual-spatial skills. Finally, in their anamnesis a higher comorbidity with neurodevelopmental disorders such as specific learning disorder has been underlined.
The identification of specific deficit in neuropsychological profile of ARFID patients could be a rehabilitation target, together with standardized treatment.
Although executive impairment has been reported in mania, its brain functional correlates have been relatively little studied. This study examined goal management, believed to be more closely related to executive impairment in daily life than other executive tasks, using a novel functional magnetic resonance imaging (fMRI) paradigm in patients in this illness phase.
Twenty-one currently manic patients with bipolar disorder and 30 matched healthy controls were scanned while performing the Computerized Multiple Elements Test (CMET). This requires participants to sequentially play four simple games, with transition between games being made either voluntarily (executive condition) or automatically (control condition).
CMET performance was impaired in the manic patients compared to the healthy controls. Manic patients failed to increase activation in the lateral frontal, cingulate and inferior parietal cortex when the executive demands of the task increased, while this increase was observed in the healthy controls. Activity in these regions was associated with task performance.
Manic patients show evidence of impaired goal management, which is associated with a pattern of reduced medial and lateral frontal and parietal activity.
This chapter addresses several central issues in the study of revenge during childhood and adolescence, focusing specifically on moral evaluations of retaliation and retributive justice. We begin by distinguishing among relevant concepts and consider their respective moral status by discussing their moral-philosophical foundations. Next, we summarize and critique classic developmental psychology research on children’s reasoning about retaliation, focusing on Piaget’s (1932) early work but also addressing Kohlberg’s (1981) account when appropriate. This is followed by a discussion of social-cognitive domain theory (SCDT), a constructivist developmental perspective that we assert is better able than earlier psychological approaches to address the ambiguities of provocation, retaliation, and revenge. Consistent with recent trends in SCDT research, we also consider individual differences in children’s evaluations and responses to provocation, focusing on research investigating the social and psychological correlates of retaliatory aggression. Finally, the chapter concludes with a review of key findings and suggestions for future research.
Acute Δ9-tetrahydrocannabinol (THC) administration in humans (Lawn etal., 2016) and rats (Silveira, Adams, Morena, Hill, & Winstanley, 2016) has been associated with decreased effort allocation that may explain amotivation during acute cannabis intoxication. To date, however, whether residual effects of cannabis use on effort-based decision-making are present and observable in humans have not yet been determined. The goal of this study was to test whether prolonged cannabis use has residual effects on effort-based decision-making in 24-hr abstinent cannabis using adults.
We evaluated performance on the Effort Expenditure for Reward Task (EEfRT) in 41 adult cannabis users (mean age = 24.63 years, 21 males) and 45 nonusers (mean age = 23.90 years, 19 males). A mixed 2x3x3 ANOVA with age as a covariate was performed to examine the effect of group, probability of winning, and reward amount on EEfRT performance. EEfRT performance was operationalized as % of trials for which the hard (vs. easy) condition was chosen. Pearson’s correlations were conducted to test the relationship between EEfRT performance and measures of cannabis use, anhedonia and motivation.
We found that cannabis users selected hard trials significantly more than nonusers regardless of win probability or reward level. Frequency of cannabis use was positively correlated with amount of % hard trials chosen. There were no significant correlations between % hard trials chosen, self-reported anhedonia, or motivation.
These results suggest that unlike acute effects, residual effects of cannabis following 24 hrs of abstinence are associated with greater effort allocation during effort-based decision-making.
Cannabis use has increased dramatically across the country; however, few studies have assessed the long-term impact of medical cannabis (MC) use on cognition. Studies examining recreational cannabis users generally report cognitive decrements, particularly in those with adolescent onset. As MC patients differ from recreational consumers in motives for use, product selection, and age of onset, we assessed cognitive and clinical measures in well-characterized MC patients over 1 year. Based on previous findings, we hypothesized MC patients would not show decrements and might instead demonstrate improvements in executive function over time.
As part of an ongoing study, MC patients completed a baseline visit prior to initiating MC and evaluations following 3, 6, and 12 months of treatment. At each visit, patients completed a neurocognitive battery assessing executive function, verbal learning/memory, and clinical scales assessing mood, anxiety, and sleep. Exposure to delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) was also quantified.
Relative to baseline, MC patients demonstrated significant improvements on measures of executive function and clinical state over the course of 12 months; verbal learning/memory performance generally remained stable. Improved cognitive performance was not correlated with MC use; however, clinical improvement was associated with higher CBD use. Analyses suggest cognitive improvements were associated with clinical improvement.
Study results extend previous pilot findings, indicating that MC patients may exhibit enhanced rather than impaired executive function over time. Future studies should examine distinctions between recreational and MC use to identify potential mechanisms related to cognitive changes and the role of clinical improvement.
Bilingual children typically perform more poorly than monolingual children on linguistic tasks but better than monolingual children on cognitive tasks requiring executive function. The present study examined performance on complex linguistic tasks that also required executive functioning for their solution. One hundred 4-year-olds from linguistically diverse backgrounds (36 monolinguals, 64 bilinguals) performed two linguistic tasks in which misleading information needed to be ignored to select the correct answer. Data were analyzed both categorically by comparing the performance of children assigned to monolingual and bilingual groups and continuously in terms of degree of bilingual experience across the entire sample. In the categorical analyses, bilingual children were more accurate than monolingual children in understanding the meaning of spoken sentences in the presence of distraction in both tasks, and continuous analyses showed that performance was calibrated to degree of bilingualism in one of the tasks, with higher levels of bilingualism being associated with better performance. The interpretation is that attentional control built up through bilingual experience compensates for lower levels of language proficiency in performing these complex linguistic tasks. The study also endorses the use of continuous assessments of bilingualism rather than categorical assignment to groups to obtain more nuanced results.
The Classroom Memory Study (Coffman et al., 2008) laid a foundation for understanding the ways in which teachers shape children’s memory development, but it also provides a framework for examining the acquisition of other related cognitive skills that children need to be successful in school. In this chapter, we draw on this foundation to describe new directions in research on the socialization of cognition in the school setting. First, we describe links between cognitive skills that support children’s learning in school, focusing on associations between memory skills and those associated with self-regulated learning, including metacognition and executive functions. We then outline studies linking schooling experience – including aspects of teacher language identified in the Classroom Memory Study – and self-regulated learning skills. Finally, building on this, new research focusing on the impact of instruction on the neural and behavioral correlates of student attention, a key aspect of self-regulation, will be described.
We examined parent- and adolescent-reported executive functioning (EF) behaviors following pediatric traumatic brain injury (TBI) in the context of Online Family Problem-Solving Therapy (OFPST) and moderators of change in EF behaviors.
In total, 274 families were randomized to OFPST or an internet resource comparison group. Parents and adolescents completed the Behavior Rating Inventory of Executive Function at four time points. Mixed models were used to examine EF behaviors, assessing the effects of visit, treatment group, rater, TBI severity, age, socioeconomic status, and family functioning.
Parents rated their adolescents’ EF as poorer (F(3,1156) = 220.15, p < .001; M = 58.11, SE = 0.73) than adolescents rated themselves (M = 51.81, SE = 0.73). Across raters, EF behaviors were poorer for adolescents whose parents had less education (F(3,1156) = 8.60, p = .003; M = 56.76, SE = 0.98) than for those with more education (M = 53.16, SE = 0.88). Age at baseline interacted with visit (F(3,1156) = 5.05, p = .002), such that families of older adolescents reported improvement in EF behaviors over time. Family functioning also interacted with visit (F(3, 1156) = 2.61, p = .049), indicating more improvement in EF behaviors over time in higher functioning families. There were no effects of treatment or TBI severity.
We identified a discrepancy between parent- and adolescent-reported EF, suggesting reduced awareness of deficits in adolescents with TBI. We also found that poorer family functioning and younger age were associated with poorer recovery after TBI, whereas adolescents of parents with less education were reported as having greater EF deficits across time points.
A major obstacle in understanding and treating posttraumatic stress disorder (PTSD) is its clinical and neurobiological heterogeneity. To address this barrier, the field has become increasingly interested in identifying subtypes of PTSD based on dysfunction in neural networks alongside cognitive impairments that may underlie the development and maintenance of symptoms. The current study aimed to determine if subtypes of PTSD, based on normative-based cognitive dysfunction across multiple domains, have unique neural network signatures.
In a sample of 271 veterans (90% male) that completed both neuropsychological testing and resting-state fMRI, two complementary, whole-brain functional connectivity analyses explored the link between brain functioning, PTSD symptoms, and cognition.
At the network level, PTSD symptom severity was associated with reduced negative coupling between the limbic network (LN) and frontal-parietal control network (FPCN), driven specifically by the dorsolateral prefrontal cortex and amygdala Hubs of Dysfunction. Further, this relationship was uniquely moderated by executive function (EF). Specifically, those with PTSD and impaired EF had the strongest marker of LN-FPCN dysregulation, while those with above-average EF did not exhibit PTSD-related dysregulation of these networks.
These results suggest that poor executive functioning, alongside LN-FPCN dysregulation, may represent a neurocognitive subtype of PTSD.
Syntactic parsing plays a central role in the interpretation of sentences, but it is unclear to what extent non-native speakers can deploy native-like grammatical knowledge during online comprehension. The current eye-tracking study investigated how Chinese–English bilinguals and native English speakers respond to syntactic category and subcategorization information while reading sentences with object-subject ambiguities. We also obtained measures of English language experience, working memory capacity, and executive function to determine how these cognitive variables influence online parsing. During reading, monolinguals and bilinguals showed similar garden-path effects related to syntactic reanalysis, but native English speakers responded more robustly to verb subcategorization cues. Readers with greater language experience and executive function showed increased sensitivity to verb subcategorization cues, but parsing was not influenced by working memory capacity. These results are consistent with exposure-based accounts of bilingual sentence processing, and they support a link between syntactic processing and domain-general cognitive control.
People with CHD are at increased risk for executive functioning deficits. Meta-analyses of these measures in CHD patients compared to healthy controls have not been reported.
To examine differences in executive functions in individuals with CHD compared to healthy controls.
We performed a systematic review of publications from 1 January, 1986 to 15 June, 2020 indexed in PubMed, CINAHL, EMBASE, PsycInfo, Web of Science, and the Cochrane Library.
Inclusion criteria were (1) studies containing at least one executive function measure; (2) participants were over the age of three.
Data extraction and quality assessment were performed independently by two authors. We used a shifting unit-of-analysis approach and pooled data using a random effects model.
The search yielded 61,217 results. Twenty-eight studies met criteria. A total of 7789 people with CHD were compared with 8187 healthy controls. We found the following standardised mean differences: −0.628 (−0.726, −0.531) for cognitive flexibility and set shifting, −0.469 (−0.606, −0.333) for inhibition, −0.369 (−0.466, −0.273) for working memory, −0.334 (−0.546, −0.121) for planning/problem solving, −0.361 (−0.576, −0.147) for summary measures, and −0.444 (−0.614, −0.274) for reporter-based measures (p < 0.001).
Our analysis consisted of cross-sectional and observational studies. We could not quantify the effect of collinearity.
Individuals with CHD appear to have at least moderate deficits in executive functions. Given the growing population of people with CHD, more attention should be devoted to identifying executive dysfunction in this vulnerable group.
Agenesis of the corpus callosum (AgCC) is associated with a range of cognitive deficits, including mild to moderate problems in higher order executive functions evident in neuropsychological assessments. Previous research has also suggested a lack of self-awareness in persons with AgCC.
We investigated daily executive functioning and self-awareness in 36 individuals with AgCC by analyzing self-ratings on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), as well as ratings on the same instrument from close relatives. Discrepancies between self- and informant-ratings were compared to the normative sample and exploratory analyses examined possible moderating effects of participant and informant characteristics.
Significant deficiencies were found in the Behavioral Regulation and Metacognitive indices for both the self and informant results, with elevated frequency of metacognition scores in the borderline to clinical range. Informants also endorsed elevated frequency of borderline to clinically significant behavioral regulation scores. The proportion of AgCC participants whose self-ratings indicated less metacognitive impairment than informant-ratings was greater than in the normative sample. Self-ratings of behavioral regulation impairment decreased with age and informant-ratings of metacognition were higher in males than females.
These findings provide evidence that individuals with AgCC experience mild to moderate executive functioning problems in everyday behavior which are observed by others. Results also suggest a lack of self-understanding or insight into the severity of these problems in the individuals with AgCC, particularly with respect to their metacognitive functioning.
Scar models posit that heightened anxiety and depression can increase the risk for subsequent reduced executive function (EF) through increased inflammation across months. However, the majority of past research on this subject used cross-sectional designs. We therefore examined if elevated generalized anxiety disorder (GAD), major depressive disorder (MDD), and panic disorder (PD) symptoms forecasted lower EF after 20 months through heightened inflammation.
Community-dwelling adults partook in this study (n = 614; MAGE = 51.80 years, 50% females). Time 1 (T1) symptom severity (Composite International Diagnostic Interview – Short Form), T2 (2 months after T1) inflammation serum levels (C-reactive protein, fibrinogen, interleukin-6), and T3 (20 months after T1) EF (Brief Test of Adult Cognition by Telephone) were assessed. Structural equation mediation modeling was performed.
Greater T1 MDD and GAD (but not PD) severity predicted increased T2 inflammation (Cohen's d = 0.21–1.92). Moreover, heightened T2 inflammation forecasted lower T3 EF (d = −1.98 to −1.87). T2 inflammation explained 25–32% of the negative relations between T1 MDD or GAD and T3 EF. T1 GAD severity predicting T3 EF via T2 inflammation path was stronger among younger (v. older) adults. Direct effects of T1 MDD, GAD, and PD forecasting decreased T3 EF were found (d = −2.02 to −1.92). Results remained when controlling for socio-demographic, physical health, and lifestyle factors.
Inflammation can function as a mechanism of the T1 MDD or GAD–T3 EF associations. Interventions that successfully treat depression, anxiety, and inflammation-linked disorders may avert EF decrements.
Meta-tasking (MT) is an aspect of executive functioning (EF) that involves the ability to branch (i.e., to apply “if-then” rules) and to effectively interleave sub-goals of one task with sub-goals of another task. As such, MT is crucial for successful planning, coordination, and execution of multiple complex tasks in daily life. Traditional tests of EF fail to adequately measure MT. This study examined whether Condition 4 of the Color-Word Interference Test (CWIT-4; the inhibition/switching condition that requires branching) predicted MT beyond Condition 3 (CWIT-3; inhibition-only condition) and beyond other subtests from the Delis–Kaplan Executive Function System (D-KEFS) that have a switching condition.
Ninety-eight non-Hispanic white community-dwelling older adults completed the first four subtests of the D-KEFS and an ecologically valid measure of MT.
Time to completion and total errors on CWIT-4 accounted for variance in MT above and beyond CWIT-3 and beyond the switching conditions of other D-KEFS subtests. Results remained virtually unchanged when controlling for demographics and general cognitive status.
Among older adults, CWIT-4 is more strongly associated with MT than other D-KFES tasks. Future research should examine whether CWIT-4 relates to lapses in instrumental activities of daily living among older adults above and beyond other EF tests.
This study examined longitudinal associations between performance on the Rey–Osterrieth Complex Figure–Developmental Scoring System (ROCF-DSS) at 8 years of age and academic outcomes at 16 years of age in 133 children with dextro-transposition of the great arteries (d-TGA).
The ROCF-DSS was administered at the age of 8 and the Wechsler Individual Achievement Test, First and Second Edition (WIAT/WIAT-II) at the ages of 8 and 16, respectively. ROCF-DSS protocols were classified by Organization (Organized/Disorganized) and Style (Part-oriented/Holistic). Two-way univariate (ROCF-DSS Organization × Style) ANCOVAs were computed with 16-year academic outcomes as the dependent variables and socioeconomic status (SES) as the covariate.
The Organization × Style interaction was not statistically significant. However, ROCF-DSS Organization at 8 years was significantly associated with Reading, Math, Associative, and Assembled academic skills at 16 years, with better organization predicting better academic performance.
Performance on the ROCF-DSS, a complex visual-spatial problem-solving task, in children with d-TGA can forecast academic performance in both reading and mathematics nearly a decade later. These findings may have implications for identifying risk in children with other medical and neurodevelopmental disorders affecting brain development.
Language and cognitive impairments are common consequences of stroke. These difficulties persist with 60% of stroke survivors continuing to experience memory problems, 50% attention deficits and 61% communication problems long after the onset of the stroke-related impairments. Such deficits are ‘invisible’ – evident only through patient report, behavioural observation or formal assessment. The impacts of such deficits are considerable and can include prolonged hospital stays, poorer functional recovery and reduced quality of life. Effective and timely rehabilitation of language (auditory comprehension, expressive language, reading and writing) and cognitive abilities (memory, attention, spatial awareness, perception and executive function) are crucial to optimise recovery after stroke. In this chapter we review the current evidence base, relevant clinical guidelines relating to language and cognitive impairments and consider the implications for stroke rehabilitation practice and future research. Speech and language therapy offers benefit to people with aphasia after stroke; intensive intervention, if tolerated, likely augments the benefits. Interventions for deficits in all non-language cognitive domains exist, but need refining and evaluating more thoroughly with a wider range of methodologies.
Language skills and executive functions (EF) undergo rapid development during preschool years and are foundational for a wide range of life outcomes but little is known of the connections between language and EF in Swedish, typically developing children. The current pilot study included 47 mono- and multilingual children aged 4–6 and aimed at describing the relationship between language and EF and investigating potential associations to age, sex, bi-/multilingualism, socioeconomic status (SES), and aspects of preschool attendance. Measures of language and EF correlated with one another to a large extent, but also showed some differentiation, suggesting a specific link between morphosyntactic ability and inhibition. Age was a significant predictor of most but not all measures. No significant effects of sex were found, with the exception for a female advantage in nonverbal communicative behavior, assessed by a novel rating paradigm. SES did not predict language or EF, and bi- and/or multilingual children did not differ from monolingual Swedish children on language or EF measures. Findings are discussed in relation to the connection between language and EF as well as to the needs of development of reliable language, EF, and communication measures for use in the Swedish context.
This study aimed to examine the predictors of cognitive performance in patients with pediatric mild traumatic brain injury (pmTBI) and to determine whether group differences in cognitive performance on a computerized test battery could be observed between pmTBI patients and healthy controls (HC) in the sub-acute (SA) and the early chronic (EC) phases of injury.
203 pmTBI patients recruited from emergency settings and 159 age- and sex-matched HC aged 8–18 rated their ongoing post-concussive symptoms (PCS) on the Post-Concussion Symptom Inventory and completed the Cogstate brief battery in the SA (1–11 days) phase of injury. A subset (156 pmTBI patients; 144 HC) completed testing in the EC (~4 months) phase.
Within the SA phase, a group difference was only observed for the visual learning task (One-Card Learning), with pmTBI patients being less accurate relative to HC. Follow-up analyses indicated higher ongoing PCS and higher 5P clinical risk scores were significant predictors of lower One-Card Learning accuracy within SA phase, while premorbid variables (estimates of intellectual functioning, parental education, and presence of learning disabilities or attention-deficit/hyperactivity disorder) were not.
The absence of group differences at EC phase is supportive of cognitive recovery by 4 months post-injury. While the severity of ongoing PCS and the 5P score were better overall predictors of cognitive performance on the Cogstate at SA relative to premorbid variables, the full regression model explained only 4.1% of the variance, highlighting the need for future work on predictors of cognitive outcomes.