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Alzheimer's disease is primarily known for deficits in learning and retaining new information. This has long been associated with pathological changes in the mesial temporal lobes. The role of the frontal lobes in memory in Alzheimer's disease is less well understood. In this study, we examined the role of the frontal lobes in learning, recognition, and retention of new verbal information, as well as the presence of specific errors (i.e., intrusions and false-positive errors). Participants included one hundred sixty-seven patients clinically diagnosed with amnestic mild cognitive impairment or suspected Alzheimer's disease dementia who were administered the California Verbal Learning Test and completed high-resolution MRI. We confirmed the role of the mesial temporal lobes in learning and retention, including the volumes of the hippocampus, entorhinal cortex, and parahippocampal gyrus. In addition, false-positive errors were associated with all volumes of the mesial temporal lobes and widespread areas within the frontal lobes. Errors of intrusion were related to the supplementary motor cortex and hippocampus. Most importantly, the mesial temporal lobes interacted with the frontal lobes for learning, recognition, and memory errors. Lower volumes in both regions explained more performance variance than any single structure. This study supports the interaction of the frontal lobes with the temporal lobes in many aspects of memory in Alzheimer's disease.

There has been an emphasis on understanding the detrimental effects of coronavirus disease (COVID-19) on individuals’ wellbeing. Healthcare workers, including mental health providers, may experience increased emotional and behavioral health concerns to a greater degree than the general public. The objective of the present study was to examine the frequency and the perceived effectiveness of various coping strategies implemented by mental health practitioners during the COVID-19 pandemic, as well as differences across career stages (i.e., trainees versus licensed practitioners [LPs]). Survey data were collected from mental health practitioners (N = 888) assessing the strategies they used to manage COVID-19-associated anxiety/distress and the perceived effectiveness of these strategies. Bonferroni-adjusted chi-square tests and t-tests were conducted to assess differences by career stage. Overall, respondents used various coping strategies, most commonly behavioral strategies such as distraction/engaging in an enjoyable activity (88.63%), spending time with loved ones (77.82%), and exercise (72.64%). Over one-quarter reported using alcohol to cope (28.27%). Respondents generally perceived their coping strategies as somewhat to very effective; no strategies were generally perceived as ineffective. Compared to LPs, trainees were significantly more likely to manage COVID-19-related anxiety/distress using supervision (p

Amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) dementia are characterized by pathological changes to the medial temporal lobes, resulting in explicit learning and retention reductions. Studies demonstrate that implicit/procedural memory processes are relatively intact in these populations, supporting different anatomical substrates for differing memory systems. This study examined differences between explicit and procedural learning and retention in individuals with aMCI and AD dementia relative to matched healthy controls. We also examined anatomical substrates using volumetric MRI. Results revealed expected difficulties with explicit learning and retention in individuals with aMCI and AD with relatively preserved procedural memory. Explicit verbal retention was associated with medial temporal cortex volumes. However, procedural retention was not related to medial temporal or basal ganglia volumes. Overall, this study confirms the dissociation between explicit relative to procedural learning and retention in aMCI and AD dementia and supports differing anatomical substrates.

BACKGROUND There has been an emphasis on understanding detrimental effects of coronavirus disease (COVID-19) on individuals’ mental health, including increased mood symptoms, sleep and appetite disturbance, and substance use. U.S. mental health practitioners have responded by adjusting their practices, particularly related to increasing tele-mental health treatment. Healthcare workers may experience increased emotional and behavioral health concerns to a greater degree even than the general public. Mental health practitioners are not immune to psychological distress and simultaneously have an ethical imperative to maintain their wellbeing. OBJECTIVE The purpose of the present study was to descriptively examine the frequency with which U.S. mental health practitioners use various coping strategies and the perceived effectiveness of these strategies during the COVID-19 pandemic. Further, the study explored how use of coping strategies and their perceived effectiveness differed for mental health providers across career stages (i.e., trainees versus licensed practitioners [LPs]). METHODS Qualtrics survey data were collected from mental health practitioners (N = 888) as part of a larger study surveying responses to the COVID-19 pandemic. Participants were asked about the strategies they were using to manage COVID-19-associated anxiety/distress and how effective they perceived their chosen strategies to be (1 = very ineffective to 5 = very effective). Bonferroni-adjusted chi-square tests and t-tests were conducted to assess differences by career stage. RESULTS Overall, respondents used various coping strategies to manage COVID-19-related anxiety/distress. Behavioral strategies were most common, particularly distraction/engaging in an enjoyable activity (88.63%), spending time with loved ones (77.82%), and exercise (72.64%). Respondents reported engaging other professionals both for work-related matters (e.g., peer consultation, 56.76%) and personal matters (e.g., individual therapy or counseling, 16.10%). Over one-quarter reported using alcohol to cope (28.27%). Overall, respondents generally perceived the strategies they employed to be “somewhat” to “very effective” in managing their COVID-19-related anxiety/distress; no strategies were generally perceived as ineffective. Compared to licensed practitioners, trainees were significantly more likely to manage COVID-19-related anxiety/distress using supervision (p < .001) and substances other than alcohol or tobacco (p = .001). There were no statistically significant differences in how effective trainees and LPs perceived each strategy. CONCLUSIONS Overall, a vast majority of U.S. mental health practitioners – trainees and LPs alike – reported using predominantly behavioral coping strategies, which they perceived to be effective, during the first months of the COVID-19 pandemic. During and after the pandemic, it will be important for mental health providers to continue to practice effective coping strategies and other forms of self-care in order to provide optimal services to their clients. The present study offers specific ways in which institutions and employers may help mental health practitioners during this stressful time, such as checking in on their wellbeing and offering substance use education, particularly to trainees.

BackgroundThe COVID-19 pandemic has been associated with increased psychological distress, signaling the need for increased mental health services in the context of stay-at-home policies.ObjectiveThis study aims to characterize how mental health practitioners have changed their practices during the pandemic. The authors hypothesize that mental health practitioners would increase tele–mental health services and that certain provider types would be better able to adapt to tele–mental health than others.MethodsThe study surveyed 903 practitioners, primarily psychologists/doctoral-level (Psych/DL) providers, social workers/master’s-level (SW/ML) providers, and neuropsychologists employed in academic medical centers or private practices. Differences among providers were examined using Bonferroni-adjusted chi-square tests and one-way Bonferroni-adjusted analyses of covariance.ResultsThe majority of the 903 mental health practitioners surveyed rapidly adjusted their practices, predominantly by shifting to tele–mental health appointments (n=729, 80.82%). Whereas 80.44% (n=625) were not using tele–mental health in December 2019, only 22.07% (n=188) were not by late March or early April 2020. Only 2.11% (n=19) reported no COVID-19–related practice adjustments. Two-thirds (596/888, 67.10%) reported providing additional therapeutic services specifically to treat COVID-19–related concerns. Neuropsychologists were less likely and Psych/DL providers and SW/ML providers were more likely than expected to transition to tele–mental health (PConclusionsThe vast majority of mental health providers in this study made practice adjustments in response to COVID-19, predominantly by rapidly transitioning to tele–mental health services. Although the majority reported providing additional therapeutic services specifically to treat COVID-19–related concerns, only a small subset endorsed offering such services to medical providers. This has implications for future practical directions, as frontline workers may begin to seek mental health treatment related to the pandemic. Despite differences in tele–mental health uptake based on provider characteristics, the majority were interested in continuing to provide such services in the future. This may help to expand clinical services to those in need via tele–mental health beyond the COVID-19 pandemic.

BACKGROUND The COVID-19 pandemic has been associated with increased psychological distress, signaling the need for increased mental health services in the context of stay-at-home policies. OBJECTIVE This study aims to characterize how mental health practitioners have changed their practices during the pandemic. The authors hypothesize that mental health practitioners would increase tele–mental health services and that certain provider types would be better able to adapt to tele–mental health than others. METHODS The study surveyed 903 practitioners, primarily psychologists/doctoral-level (Psych/DL) providers, social workers/master’s-level (SW/ML) providers, and neuropsychologists employed in academic medical centers or private practices. Differences among providers were examined using Bonferroni-adjusted chi-square tests and one-way Bonferroni-adjusted analyses of covariance. RESULTS The majority of the 903 mental health practitioners surveyed rapidly adjusted their practices, predominantly by shifting to tele–mental health appointments (n=729, 80.82%). Whereas 80.44% (n=625) were not using tele–mental health in December 2019, only 22.07% (n=188) were not by late March or early April 2020. Only 2.11% (n=19) reported no COVID-19–related practice adjustments. Two-thirds (596/888, 67.10%) reported providing additional therapeutic services specifically to treat COVID-19–related concerns. Neuropsychologists were less likely and Psych/DL providers and SW/ML providers were more likely than expected to transition to tele–mental health (PP=.01) and worked remotely more than licensed practitioners (P=.03). Despite lower rates of information technology service access (PP CONCLUSIONS The vast majority of mental health providers in this study made practice adjustments in response to COVID-19, predominantly by rapidly transitioning to tele–mental health services. Although the majority reported providing additional therapeutic services specifically to treat COVID-19–related concerns, only a small subset endorsed offering such services to medical providers. This has implications for future practical directions, as frontline workers may begin to seek mental health treatment related to the pandemic. Despite differences in tele–mental health uptake based on provider characteristics, the majority were interested in continuing to provide such services in the future. This may help to expand clinical services to those in need via tele–mental health beyond the COVID-19 pandemic.

Objective Quality of life (QOL) is a broad-ranging concept affecting an individual’s physical health, psychological state, social relationships, and relationship to their environment. Although the role of psychometrists in clinical neuropsychology is integral to the delivery of services, little is known about their QOL. The current study assessed psychometrists’ workload and aspects related to work QOL (e.g., physical and emotional exhaustion, social and work satisfaction). Method Psychometrists (N = 164) from 38 states completed a nationally distributed survey. Participants averaged eight years of experience, ~29% completed board certification, and worked primarily in general hospitals (~36%), academic medical centers (~21%), private practice (~15%), veterans/military hospitals (~13%), and rehabilitation hospitals (~12%). Results Respondents saw 5.6±2.4 (Mean±Standard Deviation) patients and spent 18.8±6.9 and 9.4±4.9 hours administering and scoring, respectively, per week. Although the majority of respondents felt satisfied with their work QOL, approximately 49% experienced emotional exhaustion, 42% experienced burnout, and 62% reported that fatigue interfered with work, family, or social life. Correlational analyses found a significant relationship between QOL variables and professional activities, particularly with time spent scoring. Additionally, patient load, time spent administering/scoring, and QOL factors varied depending on work setting. Conclusion The current study provides a novel characterization of psychometrists’ QOL. Specifically, the prevalence of emotional exhaustion and fatigue appears to be higher than in the general working population in the United States. In addition, these findings highlight the current variability of job responsibilities and QOL across work settings. Ongoing advocacy and practice adjustments for this field are indicated.

Acute mood disturbance following sport-related concussion is common and is known to adversely affect post-concussion symptoms and recovery. The physiological underpinnings of depressive symptoms following concussion, however, are relatively understudied. We hypothesized that functional connectivity of the emotional processing network would be altered in concussed athletes and associated with the severity of depressive symptoms following concussion. Forty-three concussed collegiate athletes were assessed at approximately one day (N = 34), one week (N = 34), and one month post-concussion (N = 30). Fifty-one healthy contact-sport athletes served as controls and completed a single visit. The Hamilton Rating Scale for Depression (HAM-D) was used to measure depressive symptoms. Resting state fMRI data was collected on a 3 T scanner (TR = 2 s) and functional connectivity was calculated in a meta-analytically derived network of regions associated with emotional processing. Concussed athletes had elevated depressive symptoms across the first month post-concussion relative to control athletes, but showed partial recovery by one month relative to more acute visits (ps, Highlights • Assessed association of SRC depressive symptoms and functional connectivity • Depressive symptoms observed across first month post-SRC • Altered connectivity of emotional processing regions at one month post-injury • Connectivity of emotional processing regions associated with SRC mood disturbance • Increased attention-default mode connectivity may reflect compensatory processes

Objective This paper examined how mental health practitioners adjusted their practices during COVID-19. The authors hypothesized that practitioners would transition services to telehealth but that this would differ by provider type. Method English-speaking adult mental health practitioners (N = 910) were recruited via professional listservs, personal emails, and social media. Data were collected 03/30/2020–04/10/2020 via an online Qualtrics survey asking about demographics and practice adjustments in response to COVID-19. Most practitioners were psychologists/doctoral-level therapists (41%), social workers/masters-level therapists (17%), and neuropsychologists (16%). The majority was employed in an academic medical center (19%) or private practice (22%). Differences among provider types were examined using chi-square tests with Bonferroni corrections and one-way ANOVAs with post-hoc Tukey tests. Preliminary Results (see Table 1): Most mental health practitioners adjusted their practices, primarily by transitioning to telehealth. The majority reported having easy access to information technology (IT) services. Although telehealth implementation was neutral to somewhat difficult, participants were neutral to somewhat likely to provide telehealth in the future. Compared to other practitioners, neuropsychologists saw fewer patients; were more likely to cancel, reschedule, or restrict appointments; were less likely to implement telehealth; and reported greater difficulty doing so. Findings related to other group differences (e.g., between settings) will also be presented. Conclusions During the COVID-19 outbreak, mental health practitioners rapidly shifted to telehealth, but neuropsychologists were less likely to do so and reported greater difficulty doing so. This may be related to the difficulty of administering neuropsychological tests remotely and has implications for neuropsychologists’ ability to meet patients’ needs during COVID-19.

The stress response represents an evolutionarily ancient array of biological responses to challenge or threat that facilitate survival by promoting adaptive behaviors. 'Adaptive' in the evolutionary sense, however, does not easily translate to explain stress' effect on human decisions. Much research demonstrates that acute stress alters decision-making, but outcomes are obscured by a range of methodological factors. Further, less is known about how stress affects decision-making in social contexts in which people so often act. This is of great importance in today's increasingly complex social environment, replete with potential stressors, where cooperation and trust are critical. Here the aim was to explore acute stress' effect on prosocial decision-making, while also controlling for methodological factors that may contribute to varied research outcomes. Ninety-six participants were exposed between-subjects to acute stressors with or without a significant social evaluative component, or a control procedure, after which they performed a variant of the Trust Game (a social decision-making task requiring cooperation and trust with a 'partner'). Task performance occurred at different times with respect to exposure to examine the roles of temporally distinct biological stress pathways. Overall acute stress was associated with reduced trust, but a more complex pattern emerged when accounting for individual differences in physiological stress responses via multivariate analysis. In keeping with the complexity of stress itself, acute stress may enhance or reduce propensity to trust based on an individual's unique pattern of physiological reactivity.

Few studies have examined the physiologic correlates of depressive symptoms following sport-related concussion (SRC), despite the prevalence of these symptoms following brain injury. We hypothesized that concussed athletes would have disrupted resting-state functional connectivity in emotional processing regions compared to controls, and that this disruption would be associated with greater post-concussion symptoms of depression. Forty-three concussed athletes at approximately 1 day (N = 34), 1 week (N = 34), and 1 month (N = 30) post-concussion were evaluated along with 51 healthy athletes assessed at a single visit. Resting-state fMRI was collected on a 3T GE scanner (TR = 2s); depressive symptoms were assessed using the Hamilton Rating Scale for Depression (HAM-D). Emotional processing regions of interest (ROI) were defined using an automated meta-analysis of brain regions associated with the term “emotion”. Fisher-Z transformed correlations were calculated between each ROI. A multivariate approach assessed connectivity by analyzing ROI as simultaneous response variables. Concussed athletes had significantly higher depressive symptoms relative to controls at all time points but showed partial recovery by 1-month post-concussion relative to earlier visits (p's< 0.05). Functional connectivity did not differ between controls and concussed athletes at 1 day or one-week post-concussion. However, concussed athletes had significantly different connectivity in regions associated with emotional processing at 1 month relative to 1 day post-concussion (p = 0.002), and relative to controls (p = 0.003). Follow-up analyses showed that increased connectivity between attention and default mode networks at 1-month post-concussion was common across both analyses. In addition, functional connectivity of emotional processing regions was significantly associated with depressive symptoms at 1 day (p = 0.003) and one-week post-concussion (p = 7 × 10-8), with greater HAM-D scores correlating with decreased connectivity between attention and default mode networks. These results suggest that intrinsic connectivity between default mode and attention regions following SRC may be compensatory in nature.