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.

Age, education and intellectual quotient influences: structural equation modeling on the study of Benton Visual Retention Test (BVRT)

This study searched for sociodemographic influences on visual memory and visuoconstructive ability in healthy and clinical samples evaluated with Benton Visual Retention Test (BVRT) in two studies. In Study 1, we searched for changes related to age in children, adolescents, adults and elderly on the performance of the BVRT. In Study 2, we investigated the relations among age, years of education and intellectual quotient (IQ) on the performance of the BVRT using Structural Equation Modeling (SEM). Participants were 624 individuals aged between six and 89 years old (M = 25.40; SD = 22.34) from the normatization and evidence validity studies at Brazil. We used a sociodemographic questionnaire, BVRT and IQ measure was estimated. Study 1 has shown a performance similar to the developmental graphics with a U-inverted pattern in relation to age: An increase of the visual memory ability in the children and adolescent groups as age increases, a tendency of a decrease in the performance in the adult group that intensifies in the elderly group. Study 2 found that the model for the BVRT performance tested by SEM denoted satisfactory goodness-of-fit indexes, χ2/gl = 2.67, p < .001; CFI = .92; TLI = .93; RMSEA = .004, 90% CI = [.03, .05];WLSMV = 1.79, and corroborated the theoretical assumption. The SEM model confirmed in this study highlight the strong role of years of education in the prediction of BVRT scores

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Does item difficulty affect the magnitude of the retrieval practice effect? An evaluation of the retrieval effort hypothesis

Retrieving information by testing improves subsequent retention more than restudy, a phenomenon known as the retrieval practice effect. According to the retrieval effort hypothesis (REH), difficult items require more retrieval effort than easier items and, consequently, should benefit more from retrieval practice. In two experiments, we tested this prediction. Participants learned sets of easy and difficult Swahili-Portuguese word pairs (study phase) and repeatedly restudied half of these items and repeatedly retrieval practiced the other half (practice phase). Forty-eight hours later, they took a cued-recall test (final test phase). In both experiments, we replicated both the retrieval practice and the item difficulty effects. In Experiment 1 (N = 51), we found a greater retrieval practice effect for easy items, MDifference = .26, SD = .17, than for difficult items, MDifference = .19, SD = .19, t(50) = 2.01, p = .05, d = 0.28. In Experiment 2 (N = 28), we found a nonsignificant trend-F(1, 27) = 2.86, p = .10, = .10-toward a greater retrieval practice effect for difficult items, MDifference = .28, SD = .22, than for easy items, MDifference = .18, SD = .21. This was especially true for individuals who benefit from retrieval practice (difficult: MDifference = .32, SD = .18; easy: MDifference = .20, SD = .20), t(24) = -2.08, p = .05, d = -0.42. The results provide no clear evidence for the REH and are discussed in relation to current accounts of the retrieval practice effect

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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.

Continuidad/discontinuidad de los trastornos hipercinéticos en la vida adulta / Continuity/discontinuity in hyperkinetic disorders in adulthood

Objetivo: el trastorno hipercinético, cuadro de inicio en la infancia y conocido como un trastorno de la psiquiatría infantil, tiene su espacio en la nosología psiquiátrica adulta debido a las altas tasas de continuidad del trastorno. En los diferentes estudios realizados, el 34-70% de los sujetos continúan sufriendo el trastorno de diversas formas en la vida adulta, así como altas tasas de comorbilidad psiquiátrica y la persistencia de las alteraciones neuropsicológicas presentes desde la infancia. Los objetivos del presente trabajo fueron analizar la continuidad del trastorno hipercinético en la vida adulta en una muestra de niños con el trastorno después de 13 años de seguimiento, y evaluar, en los que aún presentaban el trastorno, la psicopatología y las alteraciones neurocognitivas asociadas. Metodología: la muestra estuvo formada por 21 pacientes de un grupo inicial de 45, que cumplían criterios CIE-10 para el diagnóstico de Trastorno Hipercinético 13 años atrás, y reevaluados pasado este tiempo. Administramos un protocolo de evaluación constituido por las siguientes pruebas: Cuestionario de Achenbach (CBCL), Cuestionario de salud mental general de Goldberg (GHQ, versión de 28 ítems), Test visomotor de Bender, Test de retención visual de Benton y CPT (Continuous Performance Test). Resultados: en este estudio de seguimiento, 16 sujetos (76,9 %) continúan presentando el trastorno hipercinético en la adolescencia/adultez. Si bien existe una mejoría neurocognitiva, persisten déficits en la edad adulta, evidenciados mediante el Test de retención visual de Benton. Es de destacar que ningún sujeto de los 21 estudiados presenta comorbilidad con otro trastorno psiquiátrico (en algunos de ellos habían aparecido en algún momento de su vida síntomas del área depresiva y ansiosa, pero sin llegar a cumplir criterios diagnósticos). Hay síntomas en la infancia de las áreas hiperactiva (atención mantenida, distraibilidad), conductual (agresividad hacia objetos y hacia personas) y afectiva (ánimo, fobias e hipocondría) que están relacionados con síntomas del área ansioso-depresiva en el adulto. Igualmente, déficits en medidas atencionales en la infancia (falsos positivos en CPT) y de memoria (número de errores en el Test de Benton, puntuaciones en la figura de Rey) se relacionan con déficit neurocognitivos y alteraciones psicopatológicas en el adulto. Conclusiones: en nuestra muestra existe una clara continuidad del Trastorno Hipercinético en la vida adulta, con manifestaciones del trastorno y ligeras alteraciones neurocognitivas. Por otro lado, está ausente la comorbilidad psiquiátrica, por lo que el pronóstico en esta población no es tan negativo como se refiere en la mayoría de los estudios. Ello podría deberse a la ausencia de asociación a trastorno disocial o a cualquier otro cuadro psiquiátrico en la infancia, y a que habían seguido revisiones psiquiátricas periódicas y tratamiento psicofarmacológico hasta la vida adulta

Aim: hyperkinetic disorder, a psychiatric childhoodonset disorder, has its place in the adult nosology due to the high rates of persistence of the disorder. In various studies, 34-70% of patients continue to suffer some form of the disorder in adulthood, and high rates of psychiatric comorbidity and persistence of neuropsychological disorders present since childhood. The objectives of this study were to analyze the continuity of hyperkinetic disorder in adulthood in a sample of children with the disorder after 13 years of monitoring; and to evaluate their psychopathology and neurocognitive disorders. Methodology: the sample consisted of 21 patients from an initial group of 45 who met criteria for hyperkinetic disorder (ICD-10) 13 years ago, and re-assessed after this time. The study protocol administered was: Questionnaire CBCL, General Health Questionnaire (GHQ, 28-item version), Bender visual motor Test, Benton Visual Retention Test, and CPT (Continuous Performance Test). Results: in this follow-up study, 16 subjects (76.9%) continue to present the hyperkinetic disorder in adolescence/adulthood. While there is a neurocognitive improvement, deficits persist into adulthood as evidenced by the Benton Visual Retention Test. It is noteworthy that no subject has psychiatric comorbidity (some of them had suffered at some point in their life depressive and anxious symptoms, without fulfilling diagnostic criteria). Some symptoms in childhood hyperactive (sustained attention, distractibility), behavioral (aggression toward objects and to people) and affective areas (mood, phobias and hypochondriasis) are associated with symptoms of anxiety-depression in adulthood. Likewise, deficits in attentional measures in childhood (false positive CPT) and memory (number of errors on the Benton Test, scores on the Rey figure) are related to neurocognitive deficits and psychopathology in adults. Conclusions: in our sample there is a continuity of hyperkinetic disorder to adulthood, with manifestations of the disorder and slight neurocognitive disorders. Furthermore, psychiatric comorbidity is absent, so the prognosis in this sample is not as negative as the majority of the studies. This could be due to the lack of association with conduct disorder or other psychiatric disorders in childhood, and to the regular psychiatric reviews and psychopharmacological treatment followed until adulthood