Neuropsychological assessment, intervention, and best practices for women with non-Central nervous system cancer: A scoping review of current standards

Objective: Existing literature has sought to characterize the broad cognitive impact of non-central nervous system cancer and its treatment, including chemotherapy, radiation, surgery, and hormonal regulation. However, despite the frequency of women that are diagnosed with breast and gynecological cancer, there is limited research on the specific cognitive experiences of women undergoing cancer treatment. Presently, the current literature lacks concise guidance for neuropsychologists to support the cognitive health of women facing cancer, despite the acknowledged impact of cancer interventions and chronic illness on cognitive outcomes. Method: Applying scoping review criteria outlined by Peters et al. (2015) and adhering to Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a comprehensive examination of literature spanning multiple databases (Google Scholar, PubMed, PsychINFO) with a focus on the cognitive impact of cancer treatment on women. Conclusions: Women are subject to unique treatment-related outcomes due to the impact of hormonal alterations, differences in metabolization of certain chemotherapies, and psychosocial risk factors. Despite the known impact of cancer intervention, chronic illness, and cancer-related sequelae on cognitive outcomes, the current literature does not parsimoniously outline best practices for neuropsychologists to promote the health of women experiencing cancer. The current paper (1) provides an overview of the cognitive implications of cancer treatment with an intentional focus on cancers that are more prevalent in women versus men, (2) addresses the characteristics of this impact for women undergoing cancer intervention(s), and (3) provides possible intervention and treatment strategies for mental health providers and neuropsychologists.

The Impact of Adverse Childhood Experiences on Symptom and Performance Validity Tests Among a Multiracial Sample Presenting for ADHD Evaluation

OBJECTIVE

Adverse childhood experiences (ACEs) are commonly reported in individuals presenting for attention-deficit hyperactivity disorder (ADHD) evaluation. Performance validity tests (PVTs) and symptom validity tests (SVTs) are essential to ADHD evaluations in young adults, but extant research suggests that those who report ACEs may be inaccurately classified as invalid on these measures. The current study aimed to assess the degree to which ACE exposure differentiated PVT and SVT performance and ADHD symptom reporting in a multi-racial sample of adults presenting for ADHD evaluation.

METHOD

This study included 170 adults referred for outpatient neuropsychological ADHD evaluation who completed the ACE Checklist and a neurocognitive battery that included multiple PVTs and SVTs. Analysis of variance was used to examine differences in PVT and SVT performance among those with high (≥4) and low (≤3) reported ACEs.

RESULTS

Main effects of the ACE group were observed, such that high ACE group reporting demonstrated higher scores on SVTs assessing ADHD symptom over-reporting and infrequent psychiatric and somatic symptoms on the Minnesota Multiphasic Personality Inventory-2-Restructured Form. Conversely, no significant differences emerged in total PVT failures across ACE groups.

CONCLUSIONS

Those with high ACE exposure were more likely to have higher scores on SVTs assessing over-reporting and infrequent responses. In contrast, ACE exposure did not affect PVT performance. Thus, ACE exposure should be considered specifically when evaluating SVT performance in the context of ADHD evaluations, and more work is needed to understand factors that contribute to different patterns of symptom reporting as a function of ACE exposure.

Parental, caregiving, and family leave during clinical neuropsychology postdoctoral training: Recommendations and guidelines from the Women in Neuropsychology (WIN) committee and Education Advisory Committee (EAC) of the Society for Clinical Neuropsychology (SCN; APA division 40)

Objective: Parental and other caregiving leave is important to postdoctoral fellows, yet there is no field-wide recommendation for leave policies among clinical neuropsychology postdoctoral training programs, which is of particular relevance given the two-year requirement for eligibility for board certification. The aims of this manuscript are to (a) discuss general guidelines and recommendations for leave policies, both informed by prior empirical evidence as well as relevant existing policy guidelines from various academic and healthcare organizations, and (b) use vignettes to provide possible solutions for potential leave scenarios. Method: A critical review of literature on family leave from public policy and political science, industrial-organizational psychology, academic medicine, and psychology was conducted and findings were synthesized. Results and Conclusions: Fellowship training programs are encouraged to adopt a competency-based model that permits flexibility in leave during training without necessarily requiring an extended end date. Programs should adopt clear policies and make this information readily available to trainees and think flexibly about training options that best meet the training needs and goals of each individual. We also encourage neuropsychologists at all levels to engage in advocacy for broader systemic supports of trainees seeking equitable family leave.

A-255 Beyond The Gut: Implications of Socially-Inclusive Food Policies for the Brain

Objective: Socially-inclusive food policies impact more than physical health, namely, psychological and cognitive well-being. We will provide a comprehensive review and visual relationship of mechanisms by which sociocultural factors (via socially-inclusive food policies), impact lifelong mental/cognitive health. The relationship between diet and cognitive/mental health has implications for systematically disadvantaged communities.

Methods: Inclusion criteria: empirical studies published between 1995-2021 in English peer reviewed journals that included/addressed the impact of nutrition on mental health and/or cognition, searched for through electronic databases (e.g., Google Scholar). Keywords: terms related to nutrition (e.g., food policy, microbiome), cognition (e.g., neuropsychology, memory), development (e.g., perinatal, prenatal, older adulthood), mental health (e.g., stress, psychological outcomes).

Results: Access to food, or the lack thereof, can play a significant role in mental health and cognitive outcomes. However, the relationship between food policies and mental health is at least as complex as the relationship between food insecurity and mental stress. Specifically, the microbiota-gut-brain axis (MGB axis) shows increasing evidence linking the human microbiome to clinical psychopathology.

Conclusion: What we eat, and thereby food policies that impact what we eat and what access we have to food, significantly impact cognition and mental health via multiple mechanisms. Responses related to the MGB axis (e.g., inflammation, cerebro/cardiovascular diseases) are associated with poorer outcomes, especially in marginalized communities with limited access to healthy food and higher rates of risk factors due to systemic discrimination and inequities. Nutritional interventions and addressing nutritional deficits serve as one modifiable way to potentially prevent and reduce the severity of cognitive and mental health symptoms.

rTMS/iTBS and Cognitive Rehabilitation for Deficits Associated With TBI and PTSD: A Theoretical Framework and Review

Rehabilitation of cognitive and psychosocial deficits resulting from traumatic brain injury (TBI) continues to be an area of concern in health care. Commonly co-occurring psychiatric disorders, such as major depressive disorder and posttraumatic stress disorder, create additional hurdles when attempting to remediate cognitive sequelae. There is increased need for procedures that will yield consistent gains indicative of recovery of function. Intermittent theta-burst stimulation (iTBS), a form of repetitive transcranial magnetic stimulation, has potential as an instrument that can be tailored to aid cognitive processes and support functional gains. The use of iTBS enables direct stimulation of desired neural systems. iTBS, performed in conjunction with behavioral interventions (e.g., cognitive rehabilitation, psychotherapy), may result in additive success in facilitating cognitive restoration and adaptation. The purpose of this theoretical review is to illustrate how the technical and physiological aspects of iTBS may enhance other forms of neurorehabilitation for individuals with TBI. Future research on combinatorial iTBS interventions has the potential to translate to other complex neuropsychiatric conditions.

A scoping review of stereotype threat for BIPOC: cognitive effects and intervention strategies for the field of neuropsychology

OBJECTIVE

Abundant evidence documents stereotype threat's (ST) detrimental effect on test performance across identities and contexts (i.e., eliciting underperformance). Review of the literature shows varied aspects of both stereotyped identities and cognition are inconsistently explored across studies. Only a portion of the literature focuses on ST's impact on Black, Indigenous, and People of Color (BIPOC). It is important to understand and learn to mitigate ST, particularly for historically marginalized and systemically oppressed BIPOC patients. Relevance exists for neuropsychologists, who engage in activities (i.e., assessments) that may activate ST, and should be aware of additional factors impacting testing results and clinical decision making.

METHOD

Using scoping review criteria (Peters et al., 2015) and Preferred Reporting Item for Systemic Reviews and Meta-Analysis (PRISMA) guidelines, we reviewed literature across multiple databases (Google Scholar, PubMed, PsychINFO) on ST and cognition with a focus on BIPOC.

RESULTS

The current literature suggests that race-based ST may be implicated in underperformance for executive functioning and separately working memory. There is limited research on the effects of ST for memory, language, attention, and visuospatial skills.

CONCLUSION

Research on ST requires additional attention to establish interventions to mitigate negative effects in practice. These results provide 1) an overview of the cognitive implications of ST, 2) address the scope of this impact for BIPOC, and 3) provide possible intervention and training strategies for neuropsychologists and other clinicians to work to mitigate the effects of ST on BIPOC.

Cognition and Other Predictors of Functional Disability Among Veterans With Mild Traumatic Brain Injury and Posttraumatic Stress Disorder

BACKGROUND

Limitations in everyday functioning are frequently reported by veterans with a history of mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). Multiple factors are associated with functional disability among veterans, including depression, poor social support, cognition, and substance use. However, the degree to which these factors, particularly cognitive capacities, contribute to functional limitations remains unclear.

METHODS

We evaluated performance on tests of processing speed, executive functioning, attention, and memory as predictors of functioning on the World Health Organization Disability Assessment Scale (WHODAS) 2.0 in 288 veterans. Participants were placed in one of the following groups: PTSD-only, mTBI-only, mTBI + PTSD, and neither PTSD nor mTBI (deployed control group). Cognitive test performances were evaluated as predictors of WHODAS 2.0 functional ratings in regression models that included demographic variables and a range of mood, behavioral health, and postconcussive symptom ratings.

RESULTS

Multiple cognitive test performances predicted WHODAS 2.0 scores in the deployed control group, but they generally did not predict functioning in the clinical groups when accounting for demographics, mood, behavioral health, and postconcussive symptoms.

CONCLUSIONS

In veterans with mTBI and/or PTSD, cognitive test performances are less associated with everyday functioning than mood and postconcussive symptoms.

Can mentor organizations impact mentor outcomes? Assessing organizational norms on mentor intent to stay and willingness to "go the extra mile"

The current study explores how organizational norms within mentoring organizations predict mentor outcomes over and above individual mentor characteristics. Specifically, this study examines whether mean levels (as an indicator of organizational norms) of mentors' perceptions of their relationship quality with mentees' families predict mentor satisfaction, mentor intent to stay and mentor extra-role prosocial behavior over and above individual mentor perception of their relationship quality with mentees' families. Multilevel modeling was used to assess 204 mentors nested within 37 mentoring organizations. The current study found that mentor organization averages of perceived relationship quality with mentees' families positively predicted mentor extra-role prosocial behavior over and above the individual mentor perceptions of relationship quality with mentees' families. Additionally, organizational averages negatively predicted mentor intent to stay, while individual mentor perceptions positively predicted mentor intent to stay. Results have implications for mentoring organizations to create organizational norms that reduce burnout, increase continuity of mentor relationships, and help mentors go above and beyond on behalf of their mentees and mentoring organization.

A spectrophotometric analysis of dentinal leakage in the resected root

The purpose of this study was to compare dye leakage in the dentin of resected and nonresected roots. Fifty-four single rooted extracted teeth were used. The two groups were subdivided into young, middle age, and old age samples. Each sample was biomechanically prepared in a standard fashion and obturated using lateral condensation with sealer and gutta-percha. All root surfaces were sealed with nail polish, leaving the apical portion exposed. The apical portion of the roots were placed in 2% methylene blue dye for 72 h, rinsed, and placed in 15 ml of 35% HNO3 for 72 h. The supernatant was analyzed at 640 nm using a visible light spectrophotometer. The amount of leakage was extrapolated from a standard linear regression curve constructed from the stock 2% methylene blue dye solution. The percentage of concentration leakage in all samples ranged from less than 0.0600 to 0.1658. It was concluded that there is a greater amount of leakage in resected versus nonresected extracted teeth. The data also suggest that older teeth exhibit less leakage than younger teeth.

Autologous blood perfusion for myocardial protection during coronary angioplasty: a feasibility study

During coronary angioplasty, inflation of the balloon within the coronary artery produces transient arterial occlusion and frequently results in myocardial ischemia. Delivery of oxygenated autologous blood to the myocardium at risk during inflation may help mitigate this ischemia. Accordingly, we investigated the feasibility and safety of infusing blood through the central lumen of a dilatation catheter around the guidewire using both a model in vitro and clinical trials. In the tests in vitro, fresh blood was infused at flow rates up to 120 ml/min. Hemolysis was minimal at flow rates of 60 ml/min or less (less than or equal to 0.92 +/- 0.18%), but increased exponentially at higher rates (13.64 +/- 2.37% at 120 ml/min, p less than .002). A similar pattern was observed for potassium release. Platelet and leukocyte counts did not vary significantly, and beta-thromboglobulin and muramidase remained at control levels. Although mean erythrocyte volume did not change, erythrocyte histograms and light microscopy demonstrated a subpopulation of red cell fragments averaging 25 to 40 fl in size at higher rates. A randomized, crossover clinical trial was next performed by delivery of blood perfusion at 60 ml/min to 15 patients undergoing coronary angioplasty. Levels of plasma hemoglobin, beta-thromboglobulin, lactate dehydrogenase, and potassium remained constant before and after the perfusion and the control inflations. The maximum pain score was significantly lower with the perfusion inflation (4.1 +/- 0.8 vs 6.0 +/- 0.9, p less than .003). Relative to baseline, the maximum ST segment elevation during the perfusion inflation (0.5 +/- 0.3 mm) was nearly one-fourth that during the control inflation (1.9 +/- 0.6 mm, p less than .02). Thus, myocardial protection with oxygenated autologous blood perfusion at rates of 60 ml/min appears to be a safe and effective technique that may permit increased inflation time and extend the range of coronary angioplasty to include individuals at high risk for the procedure.

Central projections of identified Drosophila sensory neurons in relation to their time of development

Eight sensory structures (campaniform sensilla), appearing identical in the light and scanning electron microscopes, are found in specific locations on the wings of Drosophila. Their axons enter one of 2 central tracts, a medial one or a lateral one. The topographic arrangement of the sensilla on the wing is not reflected in this central projection pattern. There is, however, a strict correlation between the time when a sensillum develops and the path its axon follows: The 4 sensilla whose axons form the medial projection are born and differentiate early during the development of the wing, while the other 4 sensilla, all of which project laterally, arise during a second wave of differentiation. This time-related projection pattern remains stable in the face of a variety of genetically induced alterations in the precise number and location of sensilla.

The polarity of axon growth in the wings of Drosophila melanogaster

We have analyzed the growth of axons in the wings of the mutants Hairy wing and hairy of Drosophila melanogaster. These mutants produce many supernumerary bristle organs and sensilla campaniformia, whose axons grow between the two wing epithelia and can be visualized in both pupal and adult stages. The sensory axons of wild-type animals follow two paths in the wing, within longitudinal veins L1 and L3, and always grow with a distal to proximal polarity. In the mutants, all axons following these two paths likewise grow with correct polarity. Axons elsewhere in the wing, however, are found to grow in many different directions, including from proximal to distal and hence directly away from the central nervous system. A variety of patterns of axon growth and fasciculation are seen in different individuals. Only if the supernumerary axons encounter the two normal paths do they reliably grow toward the base of the wing. We conclude that these two paths provide polarity information for axon growth, information which is either not used or not available elsewhere in the wing in spite of the obvious morphological polarization of every epithelial cell. The time course of neural differentiation suggests that the normal sensory cells of mutant wings, which grow axons relatively early, may be the source of polarity information for the later-differentiating supernumerary cells.

Biographical predictors of scientific performance

The biographical approach to the identification of scientific talent has shown significant results in a variety of situations which included different laboratories, fields of specialization, and age groups. Much remains to be accomplished, however. The biographical approach needs to be validated in other organizational settings employing relevant criteria. Although this kind of research is being initiated, a number of studies are needed to define the advantages and limitations. The use of biographical information to identify the creative and other talents of executives, composers, administrators, and artists has been largely unexplored. Furthermore, the meaning of the biographical items has not been correlated with existing psychological theory and knowledge. All evidence to date indicates that the investigation of biographical information and its relationship to various criteria of performance and other psychological measures is a rapidly expanding area of investigation which will make further contributions to the identification of talent in a variety of fields.