It's complicated: Executive functioning moderates impacts of daily busyness on everyday functioning in community-dwelling older adults.

OBJECTIVE: Research shows that cognitively healthy older adults with mild executive function (EF) weaknesses are vulnerable to the negative impacts of life complexity (or daily busyness) when performing instrumental activities of daily living (IADLs). However, past research assessed life complexity only at one timepoint, not capturing daily fluctuations. Importantly, fluctuations in busyness can themselves have deleterious impacts on functioning. This study extended past research by examining whether (1) variability in daily busyness would be more detrimental than level of busyness to performance of IADLs, and (2) EF assessed at home would moderate deleterious impact of busyness on IADLs. METHOD: Fifty-two community-dwelling older adults aged 60 to 95 completed daily IADL tasks and daily measures of EF and busyness via ecological momentary assessment, independently at home for 18 days. RESULTS: (1) In a subset of participants with mild EF weaknesses, high variability in busyness across days was associated with fewer tasks completed correctly; and (2) across all participants (regardless of EF), high levels of daily busyness were associated with fewer tasks completed on time. CONCLUSIONS: Findings indicate that high variability in daily busyness, potentially reflecting a lack of daily routine, was associated with IADL errors among cognitively healthy older adults with mild EF weaknesses. Additionally, consistently high levels of busyness were associated with failures to complete tasks, or failures to complete them on time, regardless of EF. These results further support the Contextually Valid Executive Assessment (ConVExA) model, which posits that EF and contextual factors interact to predict functional outcomes.

Was the COVID-19 Pandemic Associated with Gender Disparities in Authorship of Manuscripts Submitted to Clinical Neuropsychology Journals?

OBJECTIVE: The COVID-19 pandemic exacerbated gender disparities in some academic disciplines. This study examined the association of the pandemic with gender authorship disparities in clinical neuropsychology (CN) journals. METHOD: Author bylines of 1,018 initial manuscript submissions to four major CN journals from March 15 through September 15 of both 2019 and 2020 were coded for binary gender. Additionally, authorship of 40 articles published on pandemic-related topics (COVID-19, teleneuropsychology) across nine CN journals were coded for binary gender. RESULTS: Initial submissions to these four CN journals increased during the pandemic (+27.2%), with comparable increases in total number of authors coded as either women (+23.0%) or men (+25.4%). Neither the average percentage of women on manuscript bylines nor the proportion of women who were lead and/or corresponding authors differed significantly across time. Moreover, the representation of women as authors of pandemic-related articles did not differ from expected frequencies in the field. CONCLUSIONS: Findings suggest that representation of women as authors of peer-reviewed manuscript submissions to some CN journals did not change during the initial months of the COVID-19 pandemic. Future studies might examine how risk and protective factors may have influenced individual differences in scientific productivity during the pandemic.

Reappraising cognitive reappraisal: The taxing impact of emotion regulation on executive functioning in older adults.

OBJECTIVE: Cognitive reappraisal (CR) and expressive suppression (ES) are two common emotion regulation strategies that share similar cognitive and neural underpinnings. Prior research has consistently shown that recent engagement in ES (both self-reported and experimentally manipulated) is associated with subsequent temporary decrements in executive functioning (EF). Thus far, only one study has examined the association between CR and EF, with null results. However, that study was limited by examining only zero-order correlations and by assessing only the speed, not accuracy, of EF performance. The present study examined multivariate relationships among recent CR, recent ES, and EF (both speed and accuracy), as well as the potential impacts of more chronic engagements in, and trait-level preferences between, the two emotion regulation strategies. METHOD: Participants were 201 community-dwelling older adults aged 60 to 93 who had participated in three separate studies examining the relationship between self-reported emotion regulation and EF. RESULTS: Recent CR was associated with EF performance accuracy above and beyond chronic CR. Both recent CR and ES contributed to EF performance accuracy uniquely beyond each other and beyond chronic and preferred emotion regulation. CONCLUSIONS: Both recent ES and CR appear to have a deleterious impact on EF performance accuracy, potentially due to utilization of similar resources; both should be accounted for when assessing emotion regulation and its impacts on EF.

Reliability and validity of composite scores from the timed subtests of the D-KEFS battery.

Many neuropsychological tests of executive functioning (EF) have test-retest reliabilities below what is considered acceptable. Combining several tests into a composite can improve reliability, although due to concerns about the multifaceted nature of the EF construct, this practice is rarely applied. The present study (a) examined internal consistencies and test-retest reliabilities of two composites of four EF tests (EF-Speed from timed scores and EF-Accuracy from error scores), and (b) preliminarily examined the criterion validity of the composites as a first step toward construct validation. Participants were 576 adults aged 18-93. Participants completed timed subtests of the Delis-Kaplan Executive Function System (D-KEFS) at baseline. A subset of participants was retested twice (at 30 min and 1 year), or once (at 6 weeks). An additional subsample completed Timed Instrumental Activities of Daily Living (TIADLs), which was used to preliminarily examine the composites' criterion validity. Internal consistency and test-retest reliabilities ranged from good to excellent for the EF-Speed composite (.809-.901) but were poor to acceptable for the EF-Accuracy composite (.510-.736). Both composites surpassed reliabilities of individual test or condition scores; one third of the examined individual speed-based scores and none of the individual error-based scores met the acceptable reliability threshold (i.e., < .7). The EF-Speed composite accounted for more variance in TIADL speed, and the EF-Accuracy in TIADL accuracy, than did any of the individual test scores, providing preliminary evidence of clinical utility and criterion validity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Daily Assessment of Executive Functioning and Expressive Suppression Predict Daily Functioning among Community-Dwelling Older Adults.

OBJECTIVE: Executive functioning (EF) is known to be associated with performance of instrumental activities of daily living (IADLs). However, prior research has found that the degree to which EF fluctuates was more predictive of self-reported cognitive and IADL lapses than was average EF performance. One source of such EF fluctuations is engagement in an emotion regulation strategy known as expressive suppression (ES). Importantly, ES has also been shown to relate to IADL performance, presumably due to its impact on EF. However, past research is limited due to assessing IADLs only in the laboratory or via self-report. The present study examined (a) the association of daily EF and ES fluctuations with performance of actual IADL tasks in participants' homes, and (b) whether any significant association between ES fluctuations and daily IADLs would be mediated by daily EF variability. METHOD: Participants were 52 older adults aged 60 to 95. Over the course of 18 days while at home, participants completed daily IADL tasks as well as daily measures of EF and ES via ecological momentary assessment. RESULTS: Contrary to our hypothesis, average EF across days predicted at-home IADLs above and beyond daily EF variability, which itself was also predictive. ES variability also predicted daily IADLs, and this association was fully mediated by average daily EF. CONCLUSIONS: Daily fluctuations in ES appear to have a deleterious impact on performance of IADLs at home, likely due to the impact of such fluctuations on EF, although the average level of EF capacity is also important.

Executive functioning interacts with complexity of daily life in predicting daily medication management among older adults.

Objective: Executive functioning (EF) is critical for performance of instrumental activities of daily living, including medication management. Under complex conditions, daily activities require greater EF resources. This study examined if older adults who exhibit weaknesses in EF are at an increased risk for mismanaging their medications under complex contexts.Method: Participants were 50 non-Hispanic white community-dwelling older adults, ages 60-85. At a baseline visit, EF was assessed using the Push-Turn-Taptap task, and daily life complexity and medication regimen complexity were assessed using a structured interview. Medication management across the subsequent 8 weeks was assessed by weekly pill counts.Results: A general linear regression using at-home medication management as the dependent variable showed that EF and the interaction between EF and life complexity were significant predictors (both p values < .001). Specifically, life complexity had a deleterious impact on medication management, but only for older adults whose EF performance was in the bottom 22% of the sample. There was no association between medication regimen complexity and accuracy of medication management.Conclusions: These findings demonstrate that older adults who have even mild EF weaknesses are at an increased risk for mismanaging their medication when leading complex daily lives. These findings add support for the Contextually Valid Executive Assessment (ConVExA) model, which asserts that EF interacts with contextual factors as a predictor of functional outcomes.

Convergent and discriminant validity of the Immediate Postconcussion Assessment and Cognitive Testing Battery (ImPACT) in young athletes.

Sports concussions are recognized as significant injuries among young athletes. Research demonstrates that return-to-play prior to becoming asymptomatic has significant repercussions including sustained cognitive deficits. Many programs have begun to use computerized testing rather than traditional neuropsychological tests to (a) determine baseline performance, (b) track symptoms, and (c) measure symptoms following concussion. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is one such tool. The current study examined ImPACT's convergent and discriminant validity by comparing scores from sports-related concussion athletes (SRC) to those from nonconcussed controls (CTL). SRC included 29 athletes, ages 12-16, referred for neuropsychological assessment following sports-related concussions. CTL included 25 healthy athletes, ages 12-16, who were concussion-free in the past year. Overall, results showed general support for ImPACT, when used to screen cognition. In fact, all ImPACT domains successfully differentiated between SRC and CTL athletes. Evidence supporting appropriate convergent validity was best for the Visual Memory domain. Further, ImPACT domains demonstrated variable discriminant validity. Overall examination of validity demonstrated that ImPACT has some weaknesses but may have utility in detecting postconcussion cognitive impairment.

Utility of the Conners' Adult ADHD Rating Scale validity scales in identifying simulated attention-deficit hyperactivity disorder and random responding.

Recent concern about malingered self-report of symptoms of attention-deficit hyperactivity disorder (ADHD) in college students has resulted in an urgent need for scales that can detect feigning of this disorder. The present study provided further validation data for a recently developed validity scale for the Conners' Adult ADHD Rating Scale (CAARS), the CAARS Infrequency Index (CII), as well as for the Inconsistency Index (INC). The sample included 139 undergraduate students: 21 individuals with diagnoses of ADHD, 29 individuals responding honestly, 54 individuals responding randomly (full or half), and 35 individuals instructed to feign. Overall, the INC showed moderate sensitivity to random responding (.44-.63) and fairly high specificity to ADHD (.86-.91). The CII demonstrated modest sensitivity to feigning (.31-.46) and excellent specificity to ADHD (.91-.95). Sequential application of validity scales had correct classification rates of honest (93.1%), ADHD (81.0%), feigning (57.1%), half random (42.3%), and full random (92.9%). The present study suggests that the CII is modestly sensitive (true positive rate) to feigned ADHD symptoms, and highly specific (true negative rate) to ADHD. Additionally, this study highlights the utility of applying the CAARS validity scales in a sequential manner for identifying feigning. (PsycINFO Database Record

The effects of symptom information coaching on the feigning of adult ADHD.

College students without ADHD may feign symptoms of ADHD to gain access to stimulant medications and academic accommodations. Unfortunately, research has shown that it can be difficult to discriminate malingered from genuine ADHD symptomatology, especially when evaluations are based only on self-report questionnaires. The present study investigated whether nonclinical college students given no additional information could feign ADHD as successfully as those who were coached on symptoms of the disorder. Similar to Jasinski et al. (2011) and other research on feigned ADHD, a battery of neuropsychological, performance validity, and self-report tests was administered. Undergraduates with no history of ADHD or other psychiatric disorders were randomly assigned to 1 of 2 simulator groups: a coached group that was given information about ADHD symptoms, or a noncoached group that was given no such information. Both simulator groups were asked to feign ADHD. Their performance was compared to a genuine ADHD group and a nonclinical group asked to respond honestly. Self-report, neuropsychological, and performance validity test data are discussed in the context of the effect of coaching and its implications for ADHD evaluations. Symptom coaching did not have a significant effect on feigning success. Performance validity tests were moderately effective at detecting feigned ADHD. (PsycINFO Database Record