Wright Institute

Psychological distress and cognitive difficulties are prevalent among postmenopausal women. While some studies suggest distress affects memory or executive functions, findings are inconsistent. We evaluated associations of psychological distress with multiple cognitive domains in postmenopausal women. The Early versus Late Intervention Trial with Estradiol was a randomized, double-blinded, placebo-controlled trial of 643 healthy postmenopausal women, conducted between 2005 and 2013. A psychosocial substudy included 448 women. In this secondary analysis, psychological distress was assessed as a latent factor using validated scales (Perceived Stress, Center for Epidemiologic Studies Depression, Liebowitz Social Anxiety, Penn State Worry Questionnaire, National Anxiety Disorders Screening Day Survey). Cognitive composite scores for executive functions, visuospatial ability, verbal memory, and visual memory were assessed three times over 5 years. Linear mixed-effect models (630 observations, 388 participants) included covariates of age, education, income, treatment assignment, carotid artery intima-media thickness, and hysterectomy status. Psychological distress was significantly associated with lower executive functions (β [95% confidence interval or CI] = -0.07 [-0.13, -0.01], p = 0.03) and visuospatial ability (β [95% CI] = -0.08 [-0.16, -0.01], p = 0.03), but not with verbal (β [95% CI] = 0.01 [-0.07, 0.09], p = 0.74) or visual memory (β [95% CI] = 0.02 [-0.06, 0.10], p = 0.63). Findings highlight the importance of addressing psychological distress as part of interventions to maintain cognitive health in postmenopausal women and the need for comprehensive models that integrate emotional and biological factors to better understand cognitive aging in this population.

Abstract U.S. Census trends indicate significantly increased numbers of older adults and thus, a greater need for medical and mental health providers equipped to address older adult needs. Since the Building Bridges Conference in March 2021, the Building Bridges Post-Licensure (BBPL) group has been working to advance clinical practice with older adults. In 2022, we conducted a needs assessment of 80 post-licensure psychologists and identified a strong desire for gero-focused case consultation. We subsequently launched two six-month pilot consultation groups, occurring monthly for 90 minutes and led separately by a board certified geropsychologist. The groups consisted of didactic teaching, case presentation, and case discussion, focusing on foundational knowledge, assessment, and intervention geropsychology competencies. Nine licensed psychologists and one licensed clinical social worker completed consultation and eight of these participants completed the post-assessment. Most agreed consultation added value to their clinical practice (62% ‘strongly agree’; 38% ‘agree), was responsive to their professional needs (75% ‘strongly agree’; 25% ‘agree’), and 88% strongly agreed they received direction with difficult cases. Qualitative accounts of skills implemented were highlighted. This presentation will describe the BBPL’s efforts in developing these groups, including recruitment strategies, structure and format of monthly groups, and outcome measures. This approach may serve as a model for other disciplines interested in developing post-licensure training and educational opportunities for providers working with older adults.

Asian American feminisms in psychology are not an identity or an ideology but an unapologetic praxis, in which theorizing and practice are closely connected and lived out. In this praxis, there is no single feminism but plural feminisms, given the complexities and diversity of the Asian American communities. In this article, we bring attention to Asian American feminisms by highlighting previous work done by Asian American feminists, identifying the complexities of conceptualizing Asian American feminisms, and illustrating how Asian American feminisms hold multiple perspectives simultaneously while combating multiple oppressions. Specifically, we discuss issues related to a restive orientation of resisting oppression and centering collective values, redefining psychological health, and healing from internalized oppression and standing with other marginalized groups.

This study investigated the relationship among school engagement, students’ emotions, and academic performance of students in grades 3-6 in South Korea. A random sampling approach was used to extract data from 1,075 students out of a total of 141,926 students who used the educational learning platform, I-TokTok, adapted as the primary Learning Management System (LMS) at the provincial level. The present study aimed to identify dimensions of school engagement by exploring the behaviors consistent with IMS Caliper Analytics Specifications, a common standard utilized for collecting learning data from digital resources. Exploratory and Confirmatory Factor Analyses revealed a three-factor model of school engagement among the 13 learning behavioral indicators: behavioral engagement, social engagement, and cognitive engagement. Students’ emotions were measured through voluntary daily activities in the platform involving reflecting on, recognizing, and recording of their emotions. Students’ academic performance was assessed with performance in math tests administered within the platform. Consistent with current literature, results demonstrated that dimensions of school engagement (i.e., behavioral and social engagement) and students’ emotions positively predicted their math performance. Lastly, school engagement mediated the relationship between students’ emotions and math performance. The present study emphasizes the importance of investigating the underlying mechanisms through which elementary students emotions and school engagement predict academic achievement in an online learning environment. This relatively new area of educational research deserves attention in the field of learning analytics. We highlight the importance of considering ways to improve both students’ emotions and their school engagement to maximize the student learning outcomes.

Objective:Many epilepsy syndromes are medically refractory, leading patients to be referred for surgical work-up to control their seizures and improve their quality of life (QOL). Although surgical treatments may reduce or stop seizures, many patients continue to present with declines in mood and/or cognition post-operatively. In addition, pre-operative QOL of patients with medically refractory epilepsy is impacted by executive function (EF). The present study aims to investigate the relationship between post-operative mood/QOL and pre-operative EF in adults with epilepsy. It was hypothesized that mood would remain stable or decline post-operatively; pre-operative EF would be a protective factor for mood decline and QOL.Participants and Methods:The sample consisted of 47 adult patients (57.4% female; Age, M= 34.02(11.59)) with medically refractory epilepsy at the UCSF Epilepsy Center. Participants were included if they received surgical treatment for their epilepsy (42.6% right anterior temporal lobectomy [ATL], 46.8% left ATL, 2.1% laser ablation, 6.4% responsive neurostimulation, 2.1% multiple surgical interventions) and received both a pre- and post-surgical neuropsychological evaluation. Most patients were right-handed (95.7% right). Mood and QOL were assessed from pre- and post-operative evaluations using the Beck Depression Inventory- Second Edition (BDI-II), Beck Anxiety Inventory (BAI), and Quality of Life in Epilepsy- 31 (QOLIE-31). Executive function was assessed using the Trail Making Test, and the Delis-Kaplan Executive Function Scale (D-KEFS) subtests Color-Word Interference (CW-I) and Verbal Fluency. Descriptive statistics were obtained for each of the measures listed. A paired sample t-test was conducted between time A and B to determine whether mood and QOL were significantly different. Two multiple regressions were conducted. One analysis for post-operative depression and QOL respectively with pre-operative EF.Results:At time A, both anxiety and depression were minimal (BDI M= 17.8, SD= 10.34; BAI M= 13; SD= 8.94). QOL was borderline clinically significant (QOLIE M= 37.46, SD= 9.74). Depression at time B was positively correlated with depression at time A (r[45]= 0.316, p=0.035). A paired sample t-test indicated that depression and QOL were significantly different at time A and time B (t[44]= 2.04, p= 0.047; t[31]= -3.34, p= 0.002), with improved scores post-operatively. Anxiety was not significantly different across time points (t[39]= 1.20, p=0.238). Multiple regression analyses indicated that pre-operative depression and EF did not predict post-operative depression (F(5,27)= 1.62, p= 0.189). Pre-operative EF (CW-I Inhibition-Switching), but not pre-operative depression, predicted post-operative QOL (F(4(24)= 3.13, p=.03, R2= .343).Conclusions:Results were somewhat discrepant from prior research in that depression and QOL improved post-surgically. Notably, while the observed change in depression was statistically significant it was not clinically significant according to literature (Doherty et al., 2021). Pre-surgical inhibitory control predicted QOL, illustrating that EF may serve as a protective factor post-surgically. The present study did not include a measure of seizure freedom classification post-operatively, therefore, future studies should investigate how seizure freedom classification impacts the relationship between mood, QOL, and cognitive outcomes.

Objective:This longitudinal study investigates whether reading strategies are influenced by the orthographic depth of languages, specifically Spanish or Cantonese, acquired through enrollment in bilingual immersion programs. Spanish shares an alphabet with English and is considered a phonologically transparent language (Sun et al., 2022). Research has shown that second language learners of Cantonese, an opaque language, performed better on orthographic awareness tasks that involve whole-word visual information processing (Wang and Geva, 2003). We hypothesize that students enrolled in a bilingual immersion program will outperform peers in general education (GENED) on selected reading tasks. More specifically, those in Spanish-immersion programs will perform better on English tasks involving phonological processing; whereas those in Cantonese-immersion programs will perform better on single-word/character processing tasks.Participants and Methods:Participants (n=102) were native English speakers recruited from the San Francisco Unified School District. Our sample included 42 females and 60 males. Thirty-nine identified as White, 33 Mixed Race, 25 Asian, 4 Latinx, and 1 Black. Thirty-nine children were in GENED, 33 in Spanish immersion programs (Sp), and 30 in Cantonese immersion programs (Cn). Each child was assessed on a core language/behavioral battery at Kindergarten (T1) and 2nd-3rd grade (T2). Time 2 participants were between 7 and 9 years old.Those that scored at least one standard deviation below the mean (SS=85) on a nonverbal intelligence screener (KBIT-2 Matrices) were excluded to mitigate confounds of intellectual disabilities. Groups' performance in English was compared on English tasks involving phonological processing (CTOPP-2 Blending Words and Elision) and single-word/character information processing tasks (WJ-IV Letter Word Identification and KABC-II Rebus).Results:Simple main effects analysis showed that time did have a statistically significant effect on test performance (p <0.001). At T2, analysis revealed a significant impact of school enrollment on Blending Words [F (2, 51.0) = 4.19, p = 0.018]. As predicted, post-hoc analysis revealed the students enrolled in the Spanish-immersion program significantly outperformed those in general education on this task. Across the other three tasks, those enrolled in Spanish and Cantonese immersion programs performed as strong as or better than those in GENED, but the variability was not statistically significant.Conclusions:This study uniquely isolated the effects of bilingual education without confounding factors of access to resources of a more heterogeneous socioeconomic sample. Mixed results partially supported our hypotheses: Spanish-immersion participants performed significantly better than those in GENED on one English phonological processing task (Blending Words). Although Cantonese immersion students had a higher mean performance than those in GENED on single-word/-character processing tasks, the variance was not statistically significant. This implies that bilingual education may offer advantages in either reading strategy. According to the literature, characteristics of a language may influence literacy acquisition; thus, subsequent research may continue to examine the effect of learning multiple languages with varying levels of orthographic depth on the development of English reading strategies.

Introduction: Artificial Intelligence (AI) will fundamentally change the endoscopic assessment of patients with inflammatory bowel disease (IBD) by enabling automated, standardized interpretations to diagnose and monitor disease. An innovative application of AI is to identify patients for clinical trials via an automated endoscopic screening process known as AI-Recruitment (AI-R). This technology provides a less manual approach than current methods used to expand the identification of potential trial participants beyond those seen by study investigators. This study aims to share the experience of an IBD center utilizing AI-R to enhance IBD clinical trial recruitment. Methods: We performed a retrospective analysis comparing the experience from 11 endoscopy suites at a community-based site that incorporated Iterative Health, Inc.’s AI-R product over a period of 5 months to historical data from non-AI-R suites at the same site. Through the “always-on” AI solution, endoscopic videos were screened for presence of moderate-to-severe IBD, generating a list of potentially eligible patients for the site to confirm disease presence, type, and severity. Potentially eligible patients were approached for trial inclusion. The primary endpoint was the number of potential trial participants surfaced with AI-R compared to before AI-R was used. The secondary endpoint was time from endoscopy procedure to eligibility determination for clinical trials. Results: In the 5 months that the AI-R product was active, 300 patients were surfaced and subsequently 89% were flagged as potential IBD cases. Among them, 54% had confirmed IBD, and their disease type and severity were then identified. AI-R identified 23 potential trial participants compared to 5 before using the service. Time-to-eligibility determination decreased from 7 days to 2.5 days with AI-R. Overall, AI-R increased patient identification and reduced time-to-surface for clinical trials. Conclusion: We found that AI-R can increase the number of patients identified as potentially eligible, and ultimately enrolled, in IBD trials. In addition, it significantly decreased the time-to-surface for these patients, reducing the time burden on trial sites and allowing a quicker turnaround for trial sponsors. Further studies will be needed to understand the full potential of this technological solution beyond improved patient identification to improve recruitment efficiency, reduce screen failures, and reverse the declining trend in recruitment rates in IBD clinical trials.

Introduction: Orthopaedic Residency Directors advised against visiting subinternship rotations in the peak of the pandemic. To adapt, programs offered multiple virtual experiences. The purpose of this study was to evaluate programs and applicants perceptions regarding the value of virtual experiences during the 2020 to 2021 application cycle and their utility in future application cycles.Methods: A survey was disseminated to 31 residency programs gathering data about virtual experiences offered in this cycle. A second survey was disseminated to interns who have successfully matched at those programs to identify how interns think to have benefited from the experiences.Results: Twenty-eight programs completed the survey (90% response rate). One hundred eight new interns completed the survey (70% response rate). Virtual information sessions and resident socials were the highest attended (94% and 92%, respectively). Interns and leadership agreed that virtual rotations provided students with a good understanding of program culture and what the programs offer educationally. Neither the leadership nor the interns would recommend replacing in-person aways with virtual experiences.Conclusion: Virtual experiences helped bridge the gap after away rotations were canceled. Alongside in-person aways, virtual experiences are likely to play a role in future cycles. However, virtual experiences remain incomparable to in-person away rotations and are not recommended as a replacement.

ObjectivesPeople with bipolar disorder (BD) spend more time depressed than manic/hypomanic, and depression is associated with greater impairments in psychosocial functioning and quality of life than mania/hypomania. Emerging evidence suggests psilocybin, the psychoactive compound in “magic mushrooms,” is a promising treatment for unipolar depression. Clinical trials of psilocybin therapy have excluded people with BD as a precaution against possible adverse effects (e.g., mania). Our study centered the experiences of adults living with BD who consumed psilocybin-containing mushrooms, and aimed to (1) understand its subjective impacts on BD symptoms, (2) deepen understanding of Phase I survey results, and (3) elucidate specific contextual factors associated with adverse reactions in naturalistic settings.MethodsFollowing an international survey (Phase I), follow-up interviews were conducted with 15 respondents (Phase II) to further understand psilocybin use among adults with BD. As part of a larger mixed-methods explanatory sequential design study, reflexive thematic analysis was used to elaborate findings.ResultsThree major themes containing sub-themes were developed. (1) Mental Health Improvements: (1.1) decreased impact and severity of depression, (1.2) increased emotion processing, (1.3) development of new perspectives, and (1.4) greater relaxation and sleep. (2) Undesired Mental Health Impacts: (2.1) changes in sleep, (2.2) increased mania severity, (2.3) hospitalization, and (2.4) distressing sensory experiences. (3) Salient Contextual Factors for psilocybin use included: (3.1) poly-substance use and psilocybin dose, (3.2) solo versus social experiences, and (3.3) pre-psilocybin sleep deprivation.ConclusionOur findings demonstrate both benefits and risks of psilocybin use in this population. Carefully designed clinical trials focused on safety and preliminary efficacy are warranted.