A study protocol for a randomised trial of adjunct computerised memory specificity training (c-MeST) for major depression in youth: targeting cognitive mechanisms to enhance usual care outcomes in mental health settings.

BACKGROUND: Youth depression is highly prevalent and is related to impairments in academic, social and behavioural functioning. Evidence-based treatments are available, but many young people do not respond or sufficiently recover with first-line options, and a significant proportion experience relapse. Consequently, there is clear scope to enhance intervention in this critical period of early-onset depression. Memory specificity training (MeST) is a low-intensity intervention for depression that targets reduced specificity when recalling memories of the past, a common cognitive vulnerability in depression. This randomised controlled trial will assess the efficacy of adding a computerised version of MeST (c-MeST) to usual care for youth depression. METHODS/DESIGN: Young people aged 15-25 years with a major depressive episode (MDE) will be recruited and randomised to have immediate access to the seven session online c-MeST program in addition to usual care, or to usual care and wait-list for c-MeST. The primary outcomes will be diagnostic status of an MDE and self-reported depressive symptoms assessed at baseline, 1-, 3- and 6-month intervals. Autobiographical memory specificity and other variables thought to contribute to the maintenance of reduced memory specificity and depression will be assessed as mediators of change. DISCUSSION: Online provision of c-MeST provides a simple, low-intensity option for targeting a cognitive vulnerability that predicts the persistence of depressive symptoms. If found to be efficacious as an adjunct to usual care for depressed youth, it could be suitable for broader roll-out, as c-MeST is highly accessible and implementation requires only minimal resources due to the online and automated nature of intervention. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12619000234112p. Registered on the 18 February 2019. All items from the WHO Trial Registration Data Set can be found within the protocol. PROTOCOL VERSION: 1.0.

Normative values of the Rey Word Recognition Test in college athletes.

Improved detection of sport-related concussions can be enhanced by performance validity tests, such as the Rey Word Recognition Test (WRT). The WRT is brief and in the public domain but no norms exist for healthy college-athletes. The present study identified such normative values in a large college-athlete sample. Participants included 1,147 college-athletes, and four measures were collected: total words correct, words correct of the first 8, total number of intrusions, and combination score. The WRT was administered individually during baseline evaluations. Means and standard deviations were as follows: total correct words recognized, 10.47 (SD = 2.12); number of correct words out of the first eight words presented, 6.01 (SD = 1.41); number of intrusions, 0.89 (SD = 1.09); combination score, 15.59 (SD = 3.55). Females scored significantly higher than males in total words correct, number correct of the first eight, and combination score, and significantly lower in intrusions. The WRT proved to be a quick, easily administer test in the baseline testing setting. Only 22 athletes recognized all 15 words, and close to a normal distribution of scores was obtained, suggesting that an expectation of optimum performance by college-athletes as an inference of effortful performance would be misplaced.

Neuropsychological Test Norms in Cognitively Intact Oldest-Old.

OBJECTIVES: Individuals aged 90 or older (oldest-old), the fastest growing segment of the population, are at increased risk of developing cognitive impairment compared with younger old. Neuropsychological evaluation of the oldest-old is important yet challenging in part because of the scarcity of test norms for this group. We provide neuropsychological test norms for cognitively intact oldest-old. METHODS: Test norms were derived from 403 cognitively intact participants of The 90+ Study, an ongoing study of aging and dementia in the oldest-old. Cognitive status of intact oldest-old was determined at baseline using cross-sectional approach. Individuals with cognitive impairment no dementia or dementia (according to DSM-IV criteria) were excluded. Participants ranged in age from 90 to 102 years (mean=94). The neuropsychological battery included 11 tests (Mini-Mental Status Examination, Modified Mini-Mental State Examination, Boston Naming Test - Short Form, Letter Fluency Test, Animal Fluency Test, California Verbal Learning Test-II Short Form, Trail Making Tests A/B/C, Digit Span Forward and Backwards Test, Clock Drawing Test, CERAD Construction Subtests), and the Geriatric Depression Scale. RESULTS: Data show significantly lower scores with increasing age on most tests. Education level, sex, and symptoms of depression were associated with performance on several tests after accounting for age. CONCLUSIONS: Provided test norms will help to distinguish cognitively intact oldest-old from those with cognitive impairment. (JINS, 2019, 25, 530-545).

Multivariate Base Rates of Low Scores on Tests of Learning and Memory Among Latino Adult Populations.

OBJECTIVE: To determine the prevalence of low scores for two neuropsychological tests with five total scores that evaluate learning and memory functions. METHOD: N = 5402 healthy adults from 11 countries in Latin America and the commonwealth of Puerto Rico were administered the Rey-Osterrieth Complex Figure (ROCF) and the Hopkins Verbal Learning Test (HVLT-R). Two-thirds of the participants were women, and the average age was 53.5 ± 20.0 years. Z-scores were calculated for ROCF Copy and Memory scores and HVLT-R Total Recall, Delayed Recall, and Recognition scores, adjusting for age, age2, sex, education, and interaction variables if significant for the given country. Each Z-score was converted to a percentile for each of the five subtest scores. Each participant was categorized based on his/her number of low scoring tests in specific percentile cutoff groups (25th, 16th, 10th, 5th, and 2nd). RESULTS: Between 57.3% (El Salvador) and 64.6% (Bolivia) of the sample scored below the 25th percentile on at least one of the five scores. Between 27.1% (El Salvador) and 33.9% (Puerto Rico) scored below the 10th percentile on at least one of the five subtests. Between 5.9% (Chile, El Salvador, Peru) and 10.3% (Argentina) scored below the 2nd percentile on at least one of the five scores. CONCLUSIONS: Results are consistent with other studies that found that low scores are common when multiple neuropsychological outcomes are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores when evaluating learning and memory using various sets of scores to reduce false-positive diagnoses of cognitive deficits.

Verbal episodic memory profiles in HIV-Associated Neurocognitive Disorders (HAND): A comparison with Huntington's disease and mesial temporal lobe epilepsy.

HIV-associated neurocognitive disorders (HAND) commonly feature verbal episodic memory impairment historically characterized by a retrieval deficit, consistent with a classic "subcortical" presentation; however, there are hints of a subtle shift toward a more "cortical" memory profile characterized by a primary encoding deficit. The current study evaluated this possibility by comparing the pattern of HAND-associated verbal episodic memory deficits to those of traditional "subcortical" (i.e., Huntington's disease; HD) versus "cortical" (i.e., left temporal lobe epilepsy with mesial temporal sclerosis; L-MTLE) profiles. Seventy-seven individuals with HAND, 47 individuals with HD, 21 individuals with L-MTLE, and 45 healthy participants were administered the California Verbal Learning Test - 2nd Edition (CVLT-II). CVLT-II profiles were classified as reflecting a primary encoding deficit, retrieval deficit, or a normal profile. Among participants with a deficit profile, the HAND group showed the highest rates of retrieval versus encoding profiles (71% vs. 29%), followed by HD (59% vs. 41%), L-MTLE (46% vs. 54%), and healthy (50% vs. 50%) groups. While significant profile heterogeneity was observed across clinical groups, findings suggest that HIV-associated verbal episodic memory impairments are most consistent with a traditional "subcortical," retrieval deficit profile, consistent with the primary frontostriatal neuropathogenesis of HIV disease.

Association between self-reported and performance-based navigational ability using internet-based remote spatial memory assessment.

Traditionally, studies of spatial memory tend to utilise table-top tasks that focus on new spatial learning, however these in-lab procedures may not be reflective of real world spatial memory or navigation. This study investigated the relationship between self-rated navigation abilities and performance on a naturalistic Internet-based assessment of spatial memory for environments learned long ago. Results indicated that self-rated navigation ability was significantly associated with most of the remote spatial memory metrics. Familiarity with the geographical area tested, as well as frequency of visits, significantly predicted performance on the remote spatial memory measures. These results support the use of internet testing for performance-based navigation abilities in the assessment of remote spatial memory.

Longitudinal measurement invariance of memory performance and executive functioning in healthy aging.

In this work, we examined the longitudinal measurement invariance of a battery composed of distinct cognitive parameters. A sample of 86 individuals (53.5% females; mean age = 65.73), representative of the Portuguese older population, with respect to sex, age and level of education was assessed twice over an average of two years. By means of a confirmatory factor analysis approach, we tested whether a two-factor solution [corresponding to measures of memory performance (MEM) and executive functioning (EXEC)] was reliable over time. Nested models of longitudinal invariance demonstrated the existence of partial strong invariance over time. In other words, this indicates that there is an equivalence of the factorial structure and factor loadings for all items; this was also observed for the item intercepts for all the items, except for one of the items from the EXEC dimension. Stability coefficients revealed high associations between the dimensions over time and that, whereas there was a significant decline of the MEM across time, this was not observed for the EXEC dimension. These findings reveal that changes in MEM and EXEC scores can be attributed to true changes on these constructs, enabling the use of this battery as a reliable method to study cognitive aging.

Evaluating the contributions of task expectancy in the testing and guessing benefits on recognition memory.

Recently, we have shown that two types of initial testing (recall of a list or guessing of critical items repeated over 12 study/test cycles) improved final recognition of related and unrelated word lists relative to restudy. These benefits were eliminated, however, when test instructions were manipulated within subjects and presented after study of each list, procedures designed to minimise expectancy of a specific type of upcoming test [Huff, Balota, & Hutchison, 2016. The costs and benefits of testing and guessing on recognition memory. Journal of Experimental Psychology: Learning, Memory, and Cognition, 42, 1559-1572. doi: 10.1037/xlm0000269 ], suggesting that testing and guessing effects may be influenced by encoding strategies specific for the type of upcoming task. We follow-up these experiments by examining test-expectancy processes in guessing and testing. Testing and guessing benefits over restudy were not found when test instructions were presented either after (Experiment 1) or before (Experiment 2) a single study/task cycle was completed, nor were benefits found when instructions were presented before study/task cycles and the task was repeated three times (Experiment 3). Testing and guessing benefits emerged only when instructions were presented before a study/task cycle and the task was repeated six times (Experiments 4A and 4B). These experiments demonstrate that initial testing and guessing can produce memory benefits in recognition, but only following substantial task repetitions which likely promote task-expectancy processes.

Testing the redintegration hypothesis by a single probe recognition paradigm.

The lexicality effect in verbal short-term memory (STM), in which word lists are better recalled than nonwords lists, is considered to reflect the influence of linguistic long-term memory (LTM) knowledge on verbal STM performance. The locus of this effect remains, however, a matter of debate. The redintegrative account considers that degrading phonological traces of memoranda are reconstructed at recall by selecting lexical LTM representations that match the phonological traces. According to a strong version of this account, redintegrative processes should be strongly reduced in recognition paradigms, leading to reduced LTM effects. We tested this prediction by contrasting word and nonword memoranda in a fast encoding probe recognition paradigm. We observed a very strong lexicality effect, with better and faster recognition performance for words as compared to nonwords. These results do not support a strong version of the redintegrative account of LTM effects in STM which considers that these LTM effects would be the exclusive product of reconstruction mechanisms. If redintegration processes intervene in STM recognition tasks, they must be very fast, which at the same time provides support for models considering direct activation of lexico-semantic knowledge during verbal STM tasks.

Excitatory and inhibitory priming by attended and ignored non-recycled words with monolinguals and bilinguals.

Experiments examining identity priming from attended and ignored novel words (words that are used only once except when repetition is required due to experimental manipulation) in a lexical decision task are reported. Experiment 1 tested English monolinguals whereas Experiment 2 tested Twi (a native language of Ghana, Africa)-English bilinguals. Participants were presented with sequential pairs of stimuli composed of a prime followed by a probe, with each containing two items. The participants were required to name the target word in the prime display, and to make a lexical decision to the target item in the probe display. On attended repetition (AR) trials the probe target item was identical to the target word on the preceding attentional display. On ignored repetition (IR) trials the probe target item was the same as the distractor word in the preceding attentional display. The experiments produced facilitated (positive) priming in the AR trials and delayed (negative) priming in the IR trials. Significantly, the positive and negative priming effects also replicated across both monolingual and bilingual groups of participants, despite the fact that the bilinguals were responding to the task in their non-dominant language.

Memory and conceptual learning of relevant and non-relevant items in item-method directed forgetting.

The present research investigates the fate of non-target information when people are trying to either intentionally memorise or forget target information. By using an object-based attentional manipulation within a directed forgetting paradigm (item-method), we show a directed forgetting effect (DFE, i.e., better memory for to-be-remembered (TBR) than for to-be-forgotten (TBF) items) for items that participants are explicitly instructed to attend but not for irrelevant items that happen to be part of the context. Alongside the classic DFE, we investigate how the category of the attended and unattended items are learned. The results obtained in three experiments, show that people can successfully learn only the category of the TBR attended items and that the DFE extends to new items that are related to the old TBR and TBF items (an effect that we call conceptual DFE). These results give us new insight about how TBR and TBF items are processed and conceptually learned.

Effects of handedness consistency and saccade execution on eyewitness memory in cued- and free-recall procedures.

Identifying characteristics that distinguish between people with relatively good versus poor episodic memory is an important goal of eyewitness-memory research, as is identifying activities that can improve people's ability to retrieve episodic memories. Consistency of hand preference is a trait associated with the quality of people's episodic memory and repetitive saccade execution is an activity known to improve people's ability to retrieve episodic memories. These factors were examined in relation to cued and free recall of a staged criminal event. Individuals with inconsistent hand preference (versus consistent) remembered more on a cued-recall test and also freely recalled a larger amount of victim information. Repetitive saccade execution did not increase cued recall but did increase free recall of victim information. Theoretical implications are discussed, as is potential practical significance, with an emphasis on the size of the observed effects.

The Dot Counting Test adds up: Validation and response pattern analysis in a mixed clinical veteran sample.

OBJECTIVE: This study cross-validated the Dot Counting Test (DCT) as a performance validity test (PVT) among a mixed clinical veteran sample. Completion time and error patterns also were examined by validity group and cognitive impairment status. METHOD: This cross-sectional study included 77 veterans who completed the DCT during clinical evaluation. Seventy-four percent (N = 57) were classified as valid and 26% as noncredible (N = 20) via the Word Memory Test (WMT) and Test of Memory Malingering (TOMM). Among valid participants, 47% (N = 27) were cognitively impaired, and 53% (N = 30) were unimpaired. RESULTS: DCT performance was not significantly associated with age, education, or bilingualism. Seventy-five percent of the overall sample committed at least one error across the 12 stimulus cards; however, valid participants had a 27% higher rate of 0 errors, while noncredible participants had a 35% higher rate of ≥4 errors. Overall, noncredible individuals had significantly longer completion times, more errors, and higher E-scores. Conversely, those with cognitive impairment had longer completion times, but comparable errors to their unimpaired counterparts. Finally, DCT E-scores significantly predicted group membership with 83.1% classification accuracy and an area under the curve of .87 for identifying invalid performance. The optimal cut-score of 15 was associated with 70% sensitivity and 88% specificity. CONCLUSION: The DCT demonstrated good classification accuracy and sensitivity/specificity for identifying noncredible performance in this mixed clinical veteran sample, suggesting utility as a non-memory-based PVT with this population. Moreover, cognitive impairment significantly contributed to slower completion times, but not reduced accuracy.