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The Personal Style of the Therapist Questionnaire (PST-Q) is an instrument with more than 20 years of theoretical and empirical developments at the international scenario, especially in Latin America. The main goal of the study was to provide preliminary evidence on its psychometric properties and factorial structure in a sample of Spanish licensed clinical psychologists (N = 350). 7 confirmatory factor analysis were performed to found a 20-item and 5-factor solution that had the best fit indices and internal consistency values. The original abbreviated model of the PST-Q was partially confirmed, since item 28 had to be eliminated because it had a factor weight less than .30. The alpha values were slightly lower than the original, but equivalent to those of the Portuguese validation. The implications of the findings for training and research in Psychotherapy and Clinical Psychology are discussed.

Introduction Repeated sports-related concussion has been associated with cognitive deficits, like other forms of traumatic brain injury. Football speed players (FSP; e.g., quarterbacks) are at greater risk of cognitive impairment compared to football non-speed players (FNP). Verbal fluency is typically comprised of two tasks: letter fluency (LF) and semantic fluency (SF). Verbal clustering (production of continuous words belonging to the same category or subcategory) and switching (abandoning an exhausted semantic cluster to a new one in order to produce more words) reflect executive control and strategy use. We examined LF, SF, as well as LF and SF switching and clustering performance in retired FSP, FNP, and healthy comparison (HC) participants. Methods The sample consisted of 28 HC, 17 retired FSP, and 53 retired FNP. ANOVAs were conducted to determine group differences on LF, SF, switching, and clustering. FSP and FNP did not differ in concussion frequency. Results We found the HC group outperformed the FSP group in LF, p = 0.042, ηp2 = 0.07. For SF, the HC and FNP groups outperformed the FSP group, p = 0.013, ηp2 = 0.09. Furthermore, we found the HC group outperformed both football groups in SF switching, p = 0.000, ηp2 = 0.17. Conclusion As expected, the HC group outperformed the FSP group on LF and SF. Also, the FNP group outperformed the FSP group on SF. Interestingly, FSP displayed generally worse performances, supporting the notion that their experience of sub-concussive blows puts them at greater risk for cognitive impairment. Further investigation is needed with larger sample sizes to evaluate SF and other cognitive deficits in the FSP participants.

Objective We examined the effects of depression in traumatic brain injury (TBI) and healthy comparison (HC) adults attention/processing speed (APS) performance. Method The sample size consisted of 44 acute TBI (ATBI), 32 chronic TBI (CTBI), and 59 HC participants. The Symbol Digit Modalities Test Oral (SDMT-O) and written (SDMT-W), Stroop Color Word Test word (SCWT-W) and color (SCWT-C), and Trail Making Test part A (TMT-A) were used to evaluate APS. The Hospital Anxiety and Depression Scale was used to assess depression (HADS-D). Results ANCOVAs, controlling for age revealed the HC group outperformed both TBI groups on the SDMT-W and SCWT-C, p Conclusions Overall, the ATBI survivors underperformed on all APS tasks compared to the HC group. Furthermore, we found the CTBI group outperformed the ATBI group on several APS tasks. Our data suggests that depressive symptoms are related more to APS tasks in CTBI survivors and HC compared to ATBI survivors.

Objective Confrontation naming tests are used to examine an individual’s lexical retrieval. We examined the relationship of perceived workload and acculturation in three ethnic groups’ Cordoba Naming Test (CNT) performance. Methods The sample consisted of 32 Latinx, 11 Caucasians, and 10 Asian; all neurologically and psychologically healthy residents. All participants completed the CNT and subscales of the Abbreviated Multidimensional Acculturation Scale (AMAS) in English. AMAS was used to measure acculturation and the NASA-Task Load Index (NASA TLX) measured perceived workload. Results The CNT showed that the Caucasian group outperformed the Latinx group, p = 0.024, ηp2 = 0.14. However, the Latinx group reported better CNT performance compared to the Caucasian group, p = 0.023, ηp2 = 0.14. No differences were found between groups on the AMAS. Finally, we found a significant relationship between CNT and NASA-TLX subscales (i.e., performance, mental demand, effort, frustration, & overall perceived workload) in the Latinx group, r = −0.562 to −0.398, p Discussion Results showed the Latinx group demonstrated worse CNT performance compared to the Caucasian group. To our knowledge, this is the first study to evaluate confrontation naming performance in an ethnically diverse sample. Furthermore, we found the Latinx group reported a higher perceived performance on the CNT compared to Caucasians. Our results indicated a relationship between CNT performance and perceived workload in our Latinx sample as opposed to the Caucasian and Asian groups. Future research is needed with a larger sample size; moreover, additional research should investigate interactions between perceived workload, acculturation, and other cultural variables (e.g., bilingualism) in the interpretation of test performance in diverse ethnic groups.

Objective The United States carries a diverse Latinx population. This population largely consists of Mexicans however, there has been a population decrease since 2010. Though, the Guatemalan population has increased since 2010 and has become the third most growing population in the United States. Previous research shows that level of acculturation influences neuropsychological test performance. The Córdoba Naming Test (CNT) is a confrontation naming test created for Spanish-speakers. We examined the relationship between acculturation and CNT performance in a Latinx sample that immigrated to the United States. Method The sample consisted of 44 Mexicans and 14 Guatemalans that were neurologically and psychologically healthy residents. All the participants completed the CNT and the Abbreviated Multidimensional Acculturation Scale (AMAS) in Spanish. ANOVAs were used to examine CNT performance and acculturation on the AMAS subscales. Results Results revealed the Guatemalan immigrant group outperformed the Mexican immigrant group on the CNT, p = 0.035, ηp2 = 0.08. Additionally, we found that on the English language subscale of the AMAS, the Mexican immigrant group reported higher English language levels than the Guatemalan immigrant group, p = 0.002, ηp2 = 0.16. Conclusion Our findings showed that Guatemalans demonstrated better CNT performance compared to Mexicans. To our knowledge, this is the first study to examine confrontation naming performance in a Latinx immigrant sample. Furthermore, we found that Mexicans reported higher English language compared to Guatemalans. Future research on the CNT with larger samples should investigate possible interactions between acculturation and other cultural variables (e.g., bilingualism) in the interpretation of test performance in a Latinx immigrant population.

Objective Research shows that traumatic brain injury (TBI) patients perform worse than healthy comparisons (HC) on the Symbol Digit Modalities Test (SDMT). We evaluated cut-off scores for a newly developed recognition trial of the SDMT as a performance validity assessment in monolingual and bilingual TBI survivors and HC adults. Method The sample consisted of 43 acute TBI (ATBI; 24 monolinguals; 19 bilinguals), 32 chronic TBI (CTBI; 13 monolinguals; 19 bilinguals), and 57 HC (24 monolinguals; 33 bilinguals) participants. All participants received standardized administration of the SDMT. None of the participants displayed motivation for feigning cognitive deficits. Results The HC group outperformed both TBI groups on the demographically adjusted SDMT scores, p = 0.000, ηp2 = 0.24. An interaction emerged in SDMT scores where monolingual ATBI outperformed bilingual ATBI and bilingual CTBI outperformed monolingual CTBI, p = 0.017, ηp2 = 0.06. No differences were found in the SDMT recognition trial. Both Bichlmeier and Boone’s suggested cut-off scores had different failure rates in ATBI (Bichlmeier: 77%; Boone: 37%), CTBI (Bichlmeier: 69%; Boone: 19%), and HC (Bichlmeier: 56%; Boone: 26%). For the monolingual group (Bichlmeier: 66%; Boone: 36%) and the bilingual group (Bichlmeier: 66%; Boone: 21%). Finally, chi-squared analysis revealed monolingual TBI had greater failure rates than the bilingual ATBI. Conclusion Bichlmeier’s proposed cut-off score resulted in greater failure rates in TBI survivors compared to Boone’s suggested cut-off score. Furthermore, monolingual ATBI were influenced more by Bichlmeier’s cut-off score than the bilingual ATBI group, although the reason for this finding is unclear and requires additional study with a larger sample size.

Objective We examined two established Spanish-English bilingual norms to assess if traumatic brain injury (TBI) deficits were still found if language was no longer a variable influencing Boston Naming Test (BNT) performance. Method The sample consisted of 47 healthy comparison (HC; 24 English-Monolinguals; 23 Spanish-English Bilinguals), 33 acute TBI (ATBI; 20 English-Monolinguals; 13 Spanish-English Bilinguals), and 25 Chronic TBI (CTBI: 13 English-Monolinguals; 12 Spanish-English Bilinguals) participants. Raw scores and adjusted demographic T-scores (Roberts et al., 2002; Rosselli et al., 1997) were used to evaluate BNT performance. Results An ANCOVA controlling for age, revealed the HC group outperformed the TBI group on the BNT (raw score), p = 0.003, ηp2 = 0.11. We also found monolinguals outperformed bilinguals on the BNT, p = 0.000, ηp2 = 0.24. Using the Roberts et al., (2002) norms, we found the HC group outperformed the TBI group, p = 0.003, ηp2 = 0.11, but no language differences were found. Next, using Rosselli et al., (1997) norms, we found the HC group outperformed the TBI group on the BNT, p = 0.003, ηp2 = 0.11, and monolingual speakers outperformed bilingual speakers, p = 0.014, ηp2 = 0.06. No interactions were found. Conclusions As expected, the TBI group demonstrated worse BNT performance compared to HC group on both language norms. However, when using Roberts et al., (2002) Spanish-English bilingual norms, no language group differences were found. Our data indicates that when examining BNT performance in a Spanish-English bilingual and English-monolingual TBI sample, Roberts et al., (2002) normative data may be better suited to evaluate BNT deficits in a TBI while taking language into account.

Objective The Dot Counting Test (DCT) is a performance validity test. McCaul et al. (2018) recently revised the DCT cut-off score from ≥17 to 13.80; we evaluated the new cut-off in non-Latinx Caucasian and Caucasian Latinx traumatic brain injury (TBI) survivors and healthy comparison (HC) participants. Method The sample consisted of 37 acute TBI (ATBI; 11 Caucasian Latinx; 26 non-Latinx Caucasian), 27 chronic TBI (CTBI; 10 Caucasian Latinx; 17 non-Latinx Caucasian), and 55 HC (29 Caucasian Latinx; 26 non-Latinx Caucasian) participants. Results An ANCOVA, controlling for age, revealed no DCT E-scores differences between groups. Both the conventional and the new cut-off scores had different failure rates in ATBI (conventional cut-off: 0%; PNC: 16%), CTBI (conventional cut-off: 7%; PNC: 15%), and HC (conventional cut-off: 10%; PNC: 11%) participants. For the Caucasian Latinx group (conventional cut-off: 6%; PNC: 12%) and the non-Latinx Caucasian group (conventional cut-off: 6%; PNC: 14%), demonstrated different failure rates across cut-off scores. Group differences were found with the McCaul et al. (2018) cut-off and the conventional cut-off. Also, chi-squared analysis revealed non-Latinx Caucasian participants with ATBI had greater failure rates than Caucasian Latinx participants with ATBI. Conclusion The new DCT cut-off score resulted in greater failure rates in TBI survivors. Also, this effect appears to be most pronounced in non-Latinx Caucasian persons with ATBI. Future work should investigate possible reasons for these differences so that more stringent DCT can be utilized in a way that provides less biased results for brain injury survivors across racial and ethnic groups.

Objectives: Evaluate long-term effectiveness and tolerability of brivaracetam in clinical practice in patients with focal epilepsy. Materials and Methods: This was a multicenter retrospective study. Patients aged =16 years were started on brivaracetam from November 2016 to June 2017 and followed over 1 year. Data were obtained from medical records at 3, 6 and 12 months after treatment initiation for evaluation of safety- and seizure-related outcomes. Results: A total of 575 patients were included in analyses; most had been treated with =4 lifetime antiepileptic drugs. Target dosage was achieved by 30.6% of patients on the first day. Analysis of primary variables at 12 months revealed that mean reduction in seizure frequency was 36.0%, 39.7% of patients were =50% responders and 17.5% were seizure-free. Seizure-freedom was achieved by 37.5% of patients aged =65 years. Incidence of adverse events (AEs) and psychiatric AEs (PAEs) was 39.8% and 14.3%, respectively, and discontinuation due to these was 8.9% and 3.7%, respectively. Somnolence, irritability, and dizziness were the most frequently reported AEs. At baseline, 228 (39.7%) patients were being treated with levetiracetam; most switched to brivaracetam (dose ratio 1:10-15). Among those who switched because of PAEs (n = 53), 9 (17%) reported PAEs on brivaracetam, and 3 (5.7%) discontinued because of PAEs. Tolerability was not highly affected among patients with learning disability or psychiatric comorbidity. Conclusions: In a large population of patients with predominantly drug-resistant epilepsy, brivaracetam was effective and well-tolerated; no unexpected AEs occurred over 1 year, and the incidence of PAEs was lower compared with levetiracetam.

Background: This study aimed to synthesize the evidence of the effect of practicing Tai Chi on oxidative stress markers (OxSM). Methods: This systematic review and meta-analysis was conducting using the MEDLINE, Cochrane Library, ScienceDirect, Scopus, Epistemonikos, Lilacs, and Ovid databases to identify randomized (RCT) and non-randomized (NRCT) clinical trials that evaluated the Tai Chi effect on OxSM compared to sedentary behavior, walking or yoga. Pooled mean differences (MDs) with 95% confidence intervals (95%CI) were estimated using the inverse variance method to determine the effect of Tai Chi on OxSM. PROSPERO register: CRD42019138362. Results: Five RCT and five NRCT were included. Compared to sedentary behavior, regular Tai Chi practice increases the levels of the enzymes superoxide dismutase (MD = 34.97 U/mL, (95%CI, 9.45 to 60.48), 344 participants) and catalase (MD = 15.63 U/mL, (95%CI, 4.05 to 27.22), 110 participants), as well as reducing the levels of lipoperoxides (MD = −0.02 µmol/L, (95%CI, −0.04 to −0.00), 234 participants). For comparisons with walking or yoga, only one study per activity was identified comparing the effect on OxSM. Conclusions: Regular Tai Chi practice increases the levels of superoxide dismutase and catalase, as well as reducing the levels of lipoperoxides. More studies are necessary to determine the effect of Tai Chi on OxSM when compared to other physical activities.

Atypical femoral fractures (AFFs) are a rare but potentially devastating event, often but not always linked to bisphosphonate (BP) therapy. The pathogenic mechanisms underlying AFFs remain obscure, and there are no tests available that might assist in identifying those at high risk of AFF. We previously used exome sequencing to explore the genetic background of three sisters with AFFs and three additional unrelated AFF cases, all previously treated with BPs. We detected 37 rare mutations (in 34 genes) shared by the three sisters. Notably, we found a p.Asp188Tyr mutation in the enzyme geranylgeranyl pyrophosphate synthase, a component of the mevalonate pathway, which is critical to osteoclast function and is inhibited by N-BPs. In addition, the CYP1A1 gene, responsible for the hydroxylation of 17β-estradiol, estrone, and vitamin D, was also mutated in all three sisters and one unrelated patient. Here we present a detailed list of the variants found and report functional analyses of the GGPS1 p.Asp188Tyr mutation, which showed a severe reduction in enzyme activity together with oligomerization defects. Unlike BP treatment, this genetic mutation will affect all cells in the carriers. RNAi knockdown of GGPS1 in osteoblasts produced a strong mineralization reduction and a reduced expression of osteocalcin, osterix, and RANKL, whereas in osteoclasts, it led to a lower resorption activity. Taken together, the impact of the mutated GGPPS and the relevance of the downstream effects in bone cells make it a strong candidate for AFF susceptibility. We speculate that other genes such as CYP1A1 might be involved in AFF pathogenesis, which remains to be functionally proved. The identification of the genetic background for AFFs provides new insights for future development of novel risk assessment tools. We thank the patients for their kind participation. Funds for the study include grants SAF2014‐56562R, SAF2016‐75948‐R (Spanish MINECO), PI12/02315 (FIS, ISCII), 2014SGR932 (Catalan Government), and CIBERER (U720). This work was also supported by the Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CIBERFES; CB16/10/00245) and FEDER funds. JED was supported by the NIHR Biomedical Research Centre, Oxford, UK. NR is recipient of an FPU predoctoral fellowship from the Spanish Ministerio de Educación Cultura y Deporte. The work was also supported by a grant from the US government, NIH, NIAMS (R01 AR062054) to RB.