Faculty Bibliography

A long-standing theory for Alzheimer's disease (AD) has been that deterioration of synapses and depressed neuronal activity is a major contributing factor. We review the increasing evidence, in humans and in mouse models, that show that there is often neuronal hyperactivity at early stages rather than decreased activity. We discuss studies in mouse models showing that hyperexcitability can occur long before plaque deposition and memory impairment. In mouse models, a generator of the hyperactivity appears to be the dentate gyrus. We present evidence, based on mouse models, that inhibition of muscarinic cholinergic receptors or medial septal cholinergic neurons can prevent hyperactivity. Therefore, we hypothesize the novel idea that cholinergic neurons are overly active early in the disease, not depressed. In particular we suggest the medial septal cholinergic neurons are overly active and contribute to hyperexcitability. We further hypothesize that the high activity of cholinergic neurons at early ages ultimately leads to their decline in function later in the disease. We review the effects of a prenatal diet that increases choline, the precursor to acetylcholine and modulator of many other functions. In mouse models of AD, maternal choline supplementation (MCS) reduces medial septal cholinergic pathology, amyloid accumulation and hyperexcitability, especially in the dentate gyrus, and improves cognition.

The perinatal period represents a time of profound neurobiological, cognitive, and emotional change. While evidence points to the neuroplasticity of matrescence as adaptive in supporting the transition to motherhood, the perinatal period also entails subjective reports of cognitive difficulty known as "mommy brain" as well as a heightened vulnerability to mental health challenges. The role of cognition in the etiology of postpartum depression is a promising area of investigation into targets for maternal mental health intervention, considering evidence that important cognitive changes occur during the perinatal period, and given that cognitive alterations are key features of mood disorders. Here we review evidence for cognitive plasticity in matrescence, with a particular focus on executive function (EF) given its overlapping significance for adaptation to parenthood, central role in managing the mental load of motherhood, and implications in mood regulation and mood disorders. We also review evidence for EF changes in perinatal depression and major depressive disorder more broadly. Despite the strong association between EF impairments and major depressive disorder, research on EF changes in perinatal depression remains limited. Understanding normative EF changes during this period is essential for better understanding the relationship between EF, perinatal depression, and the mental load of motherhood. Consideration for these cognitive, neurobiological, and psychosocial factors of matrescence is critical for addressing maternal mental health and developing interventions that support parental well-being.

Firesetting behaviors are extremely dangerous not only to the individual but to society as one fire has the potential to destroy property and lead to serious injury or death. Youth firesetting behaviors are often under-assessed in psychiatric care settings intakes due to their relatively low base-rate and only are a part of a practitioner’s conceptualization when these behaviors are part of their presentation to an emergency room. Acute psychiatric care settings are well-equipped to assess and treat many highly dangerous behaviors such as active suicidal and homicidal ideation, as well as non-suicidal self-injury. However, youth firesetting is without a formal and directed plan on how to assess the risk of these behaviors, conceptualize, and intervene effectively. A case study of a 16-year-old multiracial male named “Luis”, who was psychiatrically hospitalized on an adolescent inpatient unit following multiple firesetting behaviors in the community, is used is to show the importance of multiinterdisciplinary collaboration between mental health providers and local fire safety programs. In addition, we will offer several recommendations to providers in the assessment and treatment related to juvenile who fireset

BACKGROUND/UNASSIGNED:Attention Deficit Hyperactivity Disorder (ADHD) among children younger than 6 years is quite impairing, nearly half these youth with ADHD experience school exclusion from mainstream preschool classes due to related emotional and behavioral outbursts. While a range of behavior rating scales and subjective measures are used to assess these youth, objective methods of assessment and prediction derived from technology have potential to improve therapeutic and academic interventions outcomes for these youths. We hypothesized that biometric sensors would provide objective, highly sensitive and specific information regarding the physiological status of children prior to an impulsive outburst and could be feasibly implemented using a wearable device in the special education classroom. METHODS/UNASSIGNED: = 5 youth from the first grade) of a specialized therapeutic day-school for youth with ADHD and other psychiatric and developmental disorders to examine feasibility of obtaining continuous physiological data associated with behavioral and emotional outbursts through smartwatch use. Children wore a sensor watch during their daily classroom activities for two weeks and trained observers collected data using behavioral logs. Using Ecological Momentary Assessment methodology, to examine correlations between objective sensor data and observer observation. Data collected from parents regarding prior night's sleep was also examined. RESULTS/UNASSIGNED:All participants completed the study. With a few tolerability or palatability issues. Associations were found between physiological and behavioral/questionnaire data. The methodology holds promise for reliably measuring behavioral and emotional outbursts in young children. CONCLUSIONS/UNASSIGNED:among severely dysregulated pre-school aged youth throughout a full school day. This study established the feasibility of utilizing sensor derived physiological data as an objective biomarker of ADHD within the special education therapeutic classroom. Further research with larger samples is required to build a more robust and personalized AI predictive model.

BACKGROUND/UNASSIGNED:Complementary and integrative health (CIH) services enhance physiological and psychological wellbeing, while potentially reducing medical costs. Despite these benefits, use of inpatient CIH services remains poorly characterized, impeding efforts to develop equitable and effective healthcare. OBJECTIVE/UNASSIGNED:This retrospective case-control study examined characteristics of patients likely to receive CIH referrals and consults. METHOD/UNASSIGNED:Electronic health records were analyzed from patients hospitalized at a large metropolitan academic medical center from September 2022 to February 2024. RESULTS/UNASSIGNED:values <0.001). Among those referred, 72% received at least one CIH consult, with lower odds of completing a consult for male patients. CONCLUSION/UNASSIGNED:Disparities underscore the need for equitable CIH services access in healthcare systems. Future research will test how to broaden services to male patients, those with non-English language preference, and less medical complexity, to ensure greater benefit from holistic healthcare.

INTRODUCTION/UNASSIGNED:By 2050, the U.S. population is projected to become increasingly heterogeneous, requiring a culturally competent neuropsychology workforce equipped to serve this evolving demographic. International graduate trainees bring valuable cultural and linguistic assets to the field of clinical neuropsychology but face significant structural barriers involving restrictive immigration policies. METHODS/UNASSIGNED: = 28) levels, alongside personal narratives from four international trainees. RESULTS/UNASSIGNED:Results reveal low international trainee enrollment - particularly at the postdoctoral level - and widespread immigration-related challenges, such as limited visa sponsorship and duration, unawareness of visa-related training restrictions, and discomfort among directors in supporting visa issues. Despite the potential benefits of STEM designation for clinical and counseling psychology programs to ease visa barriers, few programs have attempted and succeeded in this process. Personal narratives also highlighted the burdensome STEM conversion process, and the role of trainee-led efforts in overcoming bureaucratic hurdles. CONCLUSIONS/UNASSIGNED:To urgently address these issues, we advocate for systemic reforms including national-level STEM reclassification of psychology programs, extended visa durations, enhanced national pipelines and institutional support for visa sponsorship, and improved education on immigration policies. These efforts align with the Multicultural Orientation (MCO) model and AACN's Relevance 2050 goals by fostering a culturally and linguistically responsive workforce equipped to meet evolving mental health needs and to ensure the continued relevance of clinical neuropsychology.

INTRODUCTION/UNASSIGNED:Assessing sustained attention presents methodological challenges, particularly when spanning diverse populations whose baseline sensorimotor functioning may vary significantly. METHODS/UNASSIGNED:This study introduces the Continuous Performance Critical Stability Task (cpCST), a novel paradigm combining high-density sampling of behavior (30 Hz), individualized calibration, and fixed-difficulty assessment to measure attentional control. In a sample of 166 adults (ages 18-76), we evaluated the psychometric properties of the cpCST's instantaneous reaction time (iRT) metric derived through dynamic time warping. RESULTS/UNASSIGNED:The cpCST demonstrated exceptional reliability (bootstrap split-half r = 0.999) and predictive validity for cognitive performance (flanker and Woodcock-Johnson) and cardiorespiratory fitness (VO2submax). The task achieved high temporal efficiency, with just 2 min of data correlating at r = 0.94 with full-task performance, outperforming a standard arrow-based flanker task. The cpCST's individualized calibration effectively isolated attentional control processes from baseline sensorimotor function, eliminating age-related slowing effects typically observed in reaction time tasks. DISCUSSION/UNASSIGNED:This approach offers methodological advantages for lifespan studies, clinical populations, integration with neurophysiological measures, and computational modeling approaches while addressing limitations of existing attention assessment paradigms.

Firesetting behaviors are extremely dangerous not only to the individual but to society as one fire has the potential to destroy property and lead to serious injury or death. Youth firesetting behaviors are often under-assessed in psychiatric care settings intakes due to their relatively low base-rate and only are a part of a practitioner’s conceptualization when these behaviors are part of their presentation to an emergency room. Acute psychiatric care settings are well-equipped to assess and treat many highly dangerous behaviors such as active suicidal and homicidal ideation, as well as non-suicidal self-injury. However, youth firesetting is without a formal and directed plan on how to assess the risk of these behaviors, conceptualize, and intervene effectively. A case study of a 16-year-old multiracial male named “Luis”, who was psychiatrically hospitalized on an adolescent inpatient unit following multiple firesetting behaviors in the community, is used is to show the importance of multiinterdisciplinary collaboration between mental health providers and local fire safety programs. In addition, we will offer several recommendations to providers in the assessment and treatment related to juvenile who fireset