Alexithymia as a risk factor for poor emotional outcomes in adults with acquired brain injury.

Emotional disorders are pervasive in the acquired brain injury (ABI) population, adversely affecting quality of life and rehabilitation. This study aimed to explore the unique associative effects of alexithymia as measured by the Perth Alexithymia Questionnaire (PAQ; i.e., difficulty identifying positive/negative feelings, difficulty describing positive/negative feelings, and externally orientated thinking), on emotional outcomes as measured by the Depression Anxiety Stress Scale-21 (DASS-21) and Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment index, in 83 adults with ABI. The addition of alexithymia to hierarchical multiple regression models (controlling for demographic, injury-related, and functional outcome variables) yielded statistically significant changes in R2 for all emotional outcome measures (i.e., Depression, Anxiety, Stress, and Adjustment). Difficulty identifying negative feelings was found to be a significant unique predictor of Depression (ß = .43 p = <.001), Anxiety (ß = .40, p <.001), Stress (ß = .49, p <.001), and Adjustment (ß = .26, p = .001). Externally oriented thinking was found to be a significant unique predictor of Adjustment (ß = -.15, p = .033). These findings strengthen the argument that alexithymia, especially difficulties identifying negative feelings, may be an important risk factor for psychological distress in ABI and should be considered during early rehabilitation.

Face perception and facial emotional expression recognition ability: Both unique predictors of the broader autism phenotype.

Autism spectrum disorder (ASD) and the broader autistic phenotype (BAP) have been suggested to be associated with perceptual-cognitive difficulties processing human faces. However, the empirical results are mixed, arguably, in part due to inadequate samples and analyses. Consequently, we administered the Cambridge Face Perception Test (CFPT), the Reading the Mind in the Eyes Test (RMET), a vocabulary test, and the Autism Quotient (AQ) to a sample of 318 adults in the general community. Based on a disattenuated path analytic modelling strategy, we found that both face perception ability (ß = -.21) and facial emotional expression recognition ability (ß = -.27) predicted uniquely and significantly the Communication dimension of AQ. Vocabulary failed to yield a significant, direct effect onto the Communication dimension of the AQ. We conclude that difficulties perceiving information from the faces of others may contribute to difficulties in nonverbal communication, as conceptualised and measured within the context of BAP.

Ego-Boosting Hormone: Self-Reported and Blood-Based Testosterone Are Associated With Higher Narcissism.

Grandiose narcissism is defined as increased motivation for status and viewing oneself as entitled and superior to others. We hypothesized that these tendencies might be associated with basal levels of testosterone because testosterone is considered the most social hormone-driving dominance and the motivation to achieve social status. We distinguished between two facets of grandiose narcissism: agentic (i.e., the tendency to self-promotion in order to win others' admiration and social influence) and antagonistic (i.e., a reactive strategy used to restore threatened status). In 283 adult men, we examined the association between these facets of narcissism and blood-tested and self-reported testosterone levels. Agentic narcissism-the default narcissistic strategy-was positively associated with both testosterone indicators. Moreover, self-reported and objectively measured testosterone were positively correlated. These findings extend previous work by showing that the facets of narcissism have distinct hormonal underpinnings.

Executive function and the continued influence of misinformation: A latent-variable analysis.

Misinformation can continue to influence reasoning after correction; this is known as the continued influence effect (CIE). Theoretical accounts of the CIE suggest failure of two cognitive processes to be causal, namely memory updating and suppression of misinformation reliance. Both processes can also be conceptualised as subcomponents of contemporary executive function (EF) models; specifically, working-memory updating and prepotent-response inhibition. EF may thus predict susceptibility to the CIE. The current study investigated whether individual differences in EF could predict individual differences in CIE susceptibility. Participants completed several measures of EF subcomponents, including those of updating and inhibition, as well as set shifting, and a standard CIE task. The relationship between EF and CIE was then assessed using a correlation analysis of the EF and CIE measures, as well as structural equation modelling of the EF-subcomponent latent variable and CIE latent variable. Results showed that EF can predict susceptibility to the CIE, especially the factor of working-memory updating. These results further our understanding of the CIE's cognitive antecedents and provide potential directions for real-world CIE intervention.

Working memory capacity development through childhood: A longitudinal analysis.

Working memory is an often studied and important psychological construct. The growth of working memory capacity (WMC) in childhood is described as linear. Average adult WMC is estimated as either four or five "chunks." Using latent curve models of data from a measure of digit span backward that was administered longitudinally to a large sample representative of the native-English-speaking U.S. kindergarten population in 2011, we found that WMC growth in childhood is curvilinear. It shows an increasing yet decelerating pattern. Scoring rules (e.g., requiring 50% or 75% of trials correct) influence age-based estimates, but WMCs have likely been underestimated in children, and the average adult WMC of five is more plausible than four, as measured by digit span backward. Developmental WMC estimates, such as those reported in this research, may help others develop prescriptive learning interventions for children and understand its growth and decline across the life span. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Assessing alexithymia in adults with acquired brain injury: Psychometric properties of the Perth Alexithymia Questionnaire.

BACKGROUND: Alexithymia is a multidimensional personality trait comprised of difficulty identifying feelings, difficulty describing feelings, and externally orientated thinking. The assessment of alexithymia in people with acquired brain injury (ABI) is of clinical interest because alexithymia is linked to poor psychosocial functioning and community reintegration after ABI. To date, alexithymia measures have not been psychometrically investigated/validated in an ABI sample, restricting confident empirical work in this area. We aimed to fill this gap by assessing the psychometric properties of the Perth Alexithymia Questionnaire (PAQ) in adults with ABI and determining whether the alexithymia construct manifests similarly in ABI samples compared to the general community. METHODS: The PAQ and Depression Anxiety Stress Scales-21 were administered to an ABI sample (N = 350) and a community sample (N = 1012). Factor structure, measurement invariance, internal consistency reliability, and concurrent/discriminant validity were explored. RESULTS: Our confirmatory factor analysis of the PAQ supported the intended five-factor correlated model as the best solution, where items loaded well onto the five intended subscales. This factor structure was invariant across ABI and community samples. Good reliability and concurrent and discriminant validity were also established. LIMITATIONS: The PAQ is a self-report measure and may be impacted by insight deficits known to occur after ABI. CONCLUSION: Our data suggests that the PAQ has good validity and reliability as a measure of alexithymia. The latent structure of alexithymia manifests similarly in ABI and community samples. This study provides the first psychometric foundation for confident assessment of alexithymia in ABI.

The Effect of Self-Paced Exercise Intensity and Cardiorespiratory Fitness on Frontal Grey Matter Volume in Cognitively Normal Older Adults: A Randomised Controlled Trial.

OBJECTIVE: Exercise has been found to be important in maintaining neurocognitive health. However, the effect of exercise intensity level remains relatively underexplored. Thus, to test the hypothesis that self-paced high-intensity exercise and cardiorespiratory fitness (peak aerobic capacity; VO2peak) increase grey matter (GM) volume, we examined the effect of a 6-month exercise intervention on frontal lobe GM regions that support the executive functions in older adults. METHODS: Ninety-eight cognitively normal participants (age = 69.06 ± 5.2 years; n = 54 female) were randomised into either a self-paced high- or moderate-intensity cycle-based exercise intervention group, or a no-intervention control group. Participants underwent magnetic resonance imaging and fitness assessment pre-intervention, immediately post-intervention, and 12-months post-intervention. RESULTS: The intervention was found to increase fitness in the exercise groups, as compared with the control group (F = 9.88, p = <0.001). Changes in pre-to-post-intervention fitness were associated with increased volume in the right frontal lobe (ß = 0.29, p = 0.036, r = 0.27), right supplementary motor area (ß = 0.30, p = 0.031, r = 0.29), and both right (ß = 0.32, p = 0.034, r = 0.30) and left gyrus rectus (ß = 0.30, p = 0.037, r = 0.29) for intervention, but not control participants. No differences in volume were observed across groups. CONCLUSIONS: At an aggregate level, six months of self-paced high- or moderate-intensity exercise did not increase frontal GM volume. However, experimentally-induced changes in individual cardiorespiratory fitness was positively associated with frontal GM volume in our sample of older adults. These results provide evidence of individual variability in exercise-induced fitness on brain structure.

Sensitivity to misinformation retractions in the continued influence paradigm: Evidence for stability.

Research has consistently shown that misinformation can continue to affect inferential reasoning after a correction. This phenomenon is known as the continued influence effect (CIE). Recent studies have demonstrated that CIE susceptibility can be predicted by individual differences in stable cognitive abilities. Based on this, it was reasoned that CIE susceptibility ought to have some degree of stability itself; however, this has never been tested. The current study aimed to investigate the temporal stability of retraction sensitivity, arguably a major determinant of CIE susceptibility. Participants were given parallel forms of a standard CIE task 4 weeks apart, and the association between testing points was assessed with an intra-class correlation coefficient and confirmatory factor analysis. Results suggested that retraction sensitivity is relatively stable and can be predicted as an individual-differences variable. These results encourage continued individual-differences research on the CIE and have implications for real-world CIE intervention.

Apathy and Depression as Predictors of Activities of Daily Living Following Stroke and Traumatic Brain Injuries in Adults: A Meta-Analysis.

Apathy and depression are common sequelae of acquired brain injury (ABI). Apathy is a syndrome characterized by diminished motivation and purposeful behaviours. Depression is a mood disorder featuring sadness, worthlessness, anhedonia and suicidal ideation. Both are associated negatively with activities of daily living (ADL), the skills required to fulfil basic and complex physical needs. However, the current literature's results are inconsistent and based on relatively small sample sizes. Furthermore, the unique and combined effects of apathy and depression as predictors of ADL have not yet been estimated. This is important, as both may have implications for planning rehabilitation after an ABI. Consequently, we aimed to estimate the association between apathy, depression and ADL in the stroke and traumatic brain injured population via meta-analysis and meta-analytic path-analysis. Based on the meta-analyses (N = 1,166 to N = 1,389), we estimated the following statistically significant bivariate effects: depression and apathy (r = .53, 95% CI: .42/.63), depression and ADL (r = -.27, 95% CI: -.43/-.11), apathy and ADL (r = -.41, 95% CI: -.51/-.31). A meta-analytic mediation model found that depression had a significant indirect effect onto ADL (ß = -.17, 95% CI: -.26/-.09), while apathy had a significant direct effect (ß = -.34, 95% CI: -.48/-.19) onto ADL (model R2 = .16). We interpreted the results to suggest that apathy and depression may impact adversely on engagement with ADL in people with ABI, although the potential influence of depression on ADL may occur primarily through its influence on apathy. Thus, greater focus on apathy by practitioners may be merited in cases with ABI.

The Comprehensive Autistic Trait Inventory (CATI): development and validation of a new measure of autistic traits in the general population.

BACKGROUND: Traits and characteristics qualitatively similar to those seen in diagnosed autism spectrum disorder can be found to varying degrees in the general population. To measure these traits and facilitate their use in autism research, several questionnaires have been developed that provide broad measures of autistic traits [e.g. Autism-Spectrum Quotient (AQ), Broad Autism Phenotype Questionnaire (BAPQ)]. However, since their development, our understanding of autism has grown considerably, and it is arguable that existing measures do not provide an ideal representation of the trait dimensions currently associated with autism. Our aim was to create a new measure of autistic traits that reflects our current understanding of autism, the Comprehensive Autism Trait Inventory (CATI). METHODS: In Study 1, 107 pilot items were administered to 1119 individuals in the general population and exploratory factor analysis of responses used to create the 42-item CATI comprising six subscales: Social Interactions, Communication, Social Camouflage, Repetitive Behaviours, Cognitive Rigidity, and Sensory Sensitivity. In Study 2, the CATI was administered to 1068 new individuals and confirmatory factor analysis used to verify the factor structure. The AQ and BAPQ were administered to validate the CATI, and additional autistic participants were recruited to compare the predictive ability of the measures. In Study 3, to validate the CATI subscales, the CATI was administered to 195 new individuals along with existing valid measures qualitatively similar to each CATI subscale. RESULTS: The CATI showed convergent validity at both the total-scale (r ≥ .79) and subscale level (r ≥ .68). The CATI also showed superior internal reliability for total-scale scores (α = .95) relative to the AQ (α = .90) and BAPQ (α = .94), consistently high reliability for subscales (α > .81), greater predictive ability for classifying autism (Youden's Index = .62 vs .56-.59), and demonstrated measurement invariance for sex. LIMITATIONS: Analyses of predictive ability for classifying autism depended upon self-reported diagnosis or identification of autism. The autistic sample was not large enough to test measurement invariance of autism diagnosis. CONCLUSIONS: The CATI is a reliable and economical new measure that provides observations across a wide range of trait dimensions associated with autism, potentially precluding the need to administer multiple measures, and to our knowledge, the CATI is also the first broad measure of autistic traits to have dedicated subscales for social camouflage and sensory sensitivity.

Clinical Hypnosis as an Adjunct to Cognitive Behavior Therapy: An Updated Meta-Analysis.

In 1995, Kirsch and colleagues published an influential meta-analysis (k = 20, N = 577) which found that CBT enhanced with hypnosis (CBTH) was superior to CBT alone by at least d = .53. However, a lack of full replication and the emergence of new empirical studies prompted this updated analysis. A total of 48 post- (N = 1,928) and 25 follow-up treatments (N = 1,165) were meta-analyzed. CBTH achieved small to medium but statistically significant advantages over CBT at posttreatment (dIGPP/d = .25 to .41), and specifically in the management of depressed mood and pain. At follow-up, there was a medium sized advantage for CBTH (dIGPP/d = .54 to .59), and specifically for the treatment of obesity. These results further support the adjunctive use of hypnosis as an enhancer of CBT's efficaciousness and endurance as a treatment.

The Prevalence and Characteristics of Alexithymia in Adults Following Brain Injury: A Meta-Analysis.

Alexithymia is the inability to identify and describe one's own emotions. Some research suggests that organic alexithymia may occur after acquired brain injury (ABI). However, the results in the literature are inconsistent, when comparisons are made against healthy controls. Furthermore, a precise estimate of alexithymia prevalence in the ABI population has not yet been reported. Consequently, this meta-analysis aimed to estimate the prevalence and characteristics of alexithymia in ABI, as measured by the Toronto Alexithymia Scale-20 (TAS-20). Based on 22 unique ABI samples, a series of random-effects meta-analyses estimated moderate to large positive effect sizes (i.e., greater alexithymia in ABI samples) for the TAS-20 total scale (Hedges' g = 1.00, 95% CI [0.75, 1.35]), as well as the subscales: difficulty identifying feelings (Hedges' g = 0.92, 95% CI [0.66, 1.17]), difficulty describing feelings (Hedges' g = 0.69, 95% CI [0.50, 0.87]) and externally oriented thinking (Hedges' g = 0.75, 95% CI [0.64, 0.85]). Furthermore, a meta-regression identified a larger effect size (TAS-20 total scale score) for traumatic brain injury (TBI) samples, in comparison to non-TBI samples. Finally, the prevalence of clinically significant levels of alexithymia (TAS-20 total scale ≥ 68.4; i.e., two SDs above the general population mean) in ABI patients was estimated at 15.2%. We interpreted the results to suggest that ABI may have a substantial negative impact on affective processing abilities and, thus, comprehensive assessment of emotional functioning deficits following ABI should be considered by practitioners.

A Randomized Controlled Trial of High-Intensity Exercise and Executive Functioning in Cognitively Normal Older Adults.

BACKGROUND: There is a paucity of interventional research that systematically assesses the role of exercise intensity and cardiorespiratory fitness, and their relationship with executive function in older adults. To address this limitation, we have examined the effect of a systematically manipulated exercise intervention on executive function. METHODS: Ninety-nine cognitively normal participants (age = 69.10 ± 5.2 years; n = 54 female) were randomized into either a high-intensity cycle-based exercise, moderate-intensity cycle-based exercise, or no-intervention control group. All participants underwent neuropsychological testing and fitness assessment at baseline (preintervention), 6-month follow-up (postintervention), and 12-month postintervention. Executive function was measured comprehensively, including measures of each subdomain: Shifting, Updating/ Working Memory, Inhibition, Verbal Generativity, and Nonverbal Reasoning. Cardiorespiratory fitness was measured by analysis of peak aerobic capacity; VO2peak. RESULTS: First, the exercise intervention was found to increase cardiorespiratory fitness (VO2peak) in the intervention groups, in comparison to the control group (F =10.40, p≤0.01). However, the authors failed to find mean differences in executive function scores between the high-intensity, moderate intensity, or inactive control group. On the basis of change scores, cardiorespiratory fitness was found to associate positively with the executive function (EF) subdomains of Updating/Working Memory (ß = 0.37, p = 0.01, r = 0.34) and Verbal Generativity (ß = 0.30, p = 0.03, r = 0.28) for intervention, but not control participants. CONCLUSION: At the aggregate level, the authors failed to find evidence that 6-months of high-intensity aerobic exercise improves EF in older adults. However, it remains possible that individual differences in experimentally induced changes in cardiorespiratory fitness may be associated with changes in Updating/ Working Memory and Verbal Generativity.

Interference control in working memory: Evidence for discriminant validity between removal and inhibition tasks.

Working memory (WM) is a system for maintenance of and access to a limited number of goal-relevant representations in the service of higher cognition. Because of its limited capacity, WM requires interference-control processes, allowing us to avoid being distracted by irrelevant information. Recent research has proposed two interference-control processes, which are conceptually similar: (1) an active, item-wise removal process assumed to remove no-longer relevant information from WM, and (2) an inhibitory process assumed to suppress the activation of distractors against competing, goal-relevant representations. The purpose of this study was to determine the extent to which the tasks used to assess removal and inhibition measure the same interference-control construct. Results showed acceptable to good reliabilities for nearly all measures. Similar to previous studies, a structural equation modeling approach identified a reliable latent variable of removal. However, also similar to some previous studies, no latent variable of inhibition could be established. This was the case even when the correlation matrix used to compute the latent variable of inhibition was disattenuated for imperfect reliability. Critically, the individual measures of inhibition were unrelated to the latent variable of removal. These results provide tentative support for the notion that removal is not related to the interference-control processes assessed in inhibition tasks. This suggests that the removal process should be conceptualized as a process independent of the concept of inhibition, as proposed in computational WM models that implement removal as the "unbinding" of a WM item from the context in which it occurred.

A Meta-Analysis of Neuropsychological Predictors of Outcome Following Stroke and Other Non-Traumatic Acquired Brain Injuries in Adults.

A number of cognitive abilities have been reported to predict outcome following a non-traumatic acquired brain injury (ABI) in adults. However, the results are inconsistent. Furthermore, the unique and combined capacity of these cognitive abilities to predict ABI outcome has not been evaluated. Consequently, we employed meta-analysis and multiple regression to evaluate the capacity of various neuropsychological domains to predict two separate outcome variables in adults: (1) activities of daily living; and (2) quality of life. Based on the activities of daily living meta-analysis (N = 2384), we estimated the following significant bivariate effects: memory (r = .31, 95% CI: .20/.41]), language (r = .33, 95% CI:.26/.40), attention (r = .38, 95% CI: .30/.46]), executive functions (r = .29, 95% CI: .19/.39]), and visuospatial abilities (r = .41, 95% CI: .34/ .48). Based on the quality of life meta-analysis (N = 1037), we estimated the following significant bivariate effects: memory (r = .12, 95% CI: .03/.20]), language (r = .19, 95% CI: .06/ .32), attention (r = .30, 95% CI: .16/.44]), executive functions (r = .24, 95% CI: .12/.37) and visuospatial/constructional abilities (r = .30, 95% CI: .14/.46). Meta-analytic structural equation modelling (metaSEM) identified two significant, unique predictors of activities of daily living, attention and visuospatial abilities, and the model accounted for 21% of the variance (multiple R2 = .21, 95%CI: .16/.26). For the corresponding quality of life metaSEM, no statistically significant unique predictors were identified, however, a significant multiple correlation was observed, multiple R2 = .11 (95%CI: 04/.18). We conclude that practitioners may be able to predict, with some degree of accuracy, functional outcome following a stroke and other non-traumatic ABI in adults. We also provide some critical commentary on the nature and quality of the measures used in this area of research to represent the cognitive dimensions of interest.

A Psychometric Examination of the Anagram Persistence Task: More Than Two Unsolvable Anagrams May Not Be Better.

The purpose of this investigation was to examine a single-anagram, a double-anagram, and multi-anagram versions of the Anagram Persistence Task (APT) for factorial validity, reliability, and convergent validity. Additionally, a battery of intelligence tests was administered to examine convergent validity. Based on an unrestricted factor analysis, two factors were uncovered from the 14 anagram (seven very difficult and seven very easy) response times: test-taking persistence and verbal processing speed. The internal consistency reliabilities for the single-anagram, double-anagram, and multi-anagram (seven difficult anagrams) measures were .42, .85, and .86, respectively. Furthermore, all three versions of the APT correlated positively with intelligence test performance (r ≈ .22). However, the double-anagram and multi-anagram versions also evidenced negative, nonlinear effects with intelligence test performance (r ≈ -.15), which suggested the possibility of testee adaptation. Taking psychometrics and administration time into consideration, simultaneously, the double-anagram version of the APT may be regarded as preferred.

A comprehensive psychometric analysis of autism-spectrum quotient factor models using two large samples: Model recommendations and the influence of divergent traits on total-scale scores.

The Autism-Spectrum Quotient (AQ) is a psychometric scale that is commonly used to assess autistic-like traits and behaviors expressed by neurotypical individuals. A potential strength of the AQ is that it provides subscale scores that are specific to certain dimensions associated with autism such as social difficulty and restricted interests. However, multiple psychometric evaluations of the AQ have led to substantial disagreement as to how many factors exist in the scale, and how these factors are defined. These challenges have been exacerbated by limitations in study designs, such as insufficient sample sizes as well as a reliance on Pearson, rather than polychoric, correlations. In addition, several proposed models of the AQ suggest that some factors are uncorrelated, or negatively correlated, which has ramifications for whether total-scale scores are meaningfully interpretable-an issue not raised by previous work. The aims of the current study were to provide: (a) guidance as to which models of the AQ are viable for research purposes, and (b) evidence as to whether total-scale scores are adequately interpretable for research purposes. We conducted a comprehensive series of confirmatory factor analyses on 11 competing AQ models using two large samples drawn from an undergraduate population (n = 1,702) and the general population (n = 1,280). Psychometric evidence largely supported using the three-factor model described by Russell-Smith et al. [Personality and Individual Differences 51(2), 128-132 (2011)], but did not support the use of total-scale scores. We recommend that researchers consider using AQ subscale scores instead of total-scale scores. Autism Res 2020, 13: 45-60. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We examined 11 different ways of scoring subscales in the popular Autism-Spectrum Quotient (AQ) questionnaire in two large samples of participants (i.e., general population and undergraduate students). We found that a three-subscale model that used "Social Skill," "Patterns/Details," and "Communication/Mindreading" subscales was the best way to examine specific types of autistic traits in the AQ. We also found some weak associations between the three subscales-for example, being high on the "Patterns/Details" subscale was not predictive of scores on the other subscales. This means that meaningful interpretation of overall scores on the AQ is limited.

Correction to: Science by social media: Attitudes towards climate change are mediated by perceived social consensus.

Confidence intervals and regression lines were omitted from Fig. 1 in this article as originally published. This error was introduced during production. The original article has been corrected.