The relationship between executive function and resilience among college students- a study during COVID-19

College was already a stressful time for many individuals, and COVID has added another major stress to change college life, highlighting the importance of stress management skills and increased cognitive resilience. The goals of the current study included 1) comparing stress, executive functioning (EF), resilience, alcohol use, and school connectedness of students during the pandemic and normed data;2) examining the relationship between resilience and stress;3) investigating the effects of class standing, alcohol use, and stress on EF (self-report and performance-based measures) and resilience;4) studying the interaction of class standing, alcohol use, and stress levels after the impact of an acute stressor on EF. Participants completed the Trail Making Test and Tower of London and the Paced Auditory Serial Addition Test - Computerized followed by the Cued Go/No-Go Task. Data was collected from college students at Indiana University of Pennsylvania (n=462). Current findings indicated that students reported significantly less problematic alcohol use, alcohol use to cope, premeditation, school connectedness, as well as more stress and planning abilities than students prior to the pandemic. When comparing association among the variables, self-reported and performance-based EF were associated with resilience and school connectedness measures. Lowerclassman college students who endorsed severe stress with high problematic drinking reported less impulsive behaviors (i.e., more premeditation) than upperclassman students who endorsed severe stress with high problematic drinking. Additionally, Lowerclassman students who endorsed low problematic drinking rated themselves as possessing greater resilience than upperclassman students with high problematic drinking group. Also, upperclassmen who endorsed problematic alcohol use and severe stress made fewer omission errors than the rest of the sample after the acute stressor was presented. The current results demonstrated the changes in students' experiences during the pandemic associated with more stress than in previous cohorts, emphasizing the importance of building resources to increase students' resilience and connectedness to campus. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Supporting emotion regulation in individuals with ASD, ADHD and bipolar disorder through trauma‐informed instruction and self‐regulation strategies

Since the beginning of the COVID‐19 pandemic, students have endured drastic changes in educational routines. Such disruptions can be especially challenging for students who struggle with executive functioning, self‐regulation and emotion regulation, such as students with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and bipolar disorder. Using a framework of trauma‐informed instruction, the authors supported classroom teachers in implementing sensory spaces for students with ASD, ADHD and bipolar disorder. The project included professional development and funding for teachers to develop, procure and offer sensory tools and strategies to assist students in recognising and managing emotions. The authors collected data on the effectiveness of the sensory supports, combining teacher surveys and student behaviour data. Results indicated increased teacher knowledge on trauma‐informed instruction and use of sensory supports to promote executive functioning and self‐regulation and decreased target behaviours in students based on structured observation and anecdotal teacher feedback.

The relationship between executive function and resilience among college students- a study during COVID-19

College was already a stressful time for many individuals, and COVID has added another major stress to change college life, highlighting the importance of stress management skills and increased cognitive resilience. The goals of the current study included 1) comparing stress, executive functioning (EF), resilience, alcohol use, and school connectedness of students during the pandemic and normed data;2) examining the relationship between resilience and stress;3) investigating the effects of class standing, alcohol use, and stress on EF (self-report and performance-based measures) and resilience;4) studying the interaction of class standing, alcohol use, and stress levels after the impact of an acute stressor on EF. Participants completed the Trail Making Test and Tower of London and the Paced Auditory Serial Addition Test - Computerized followed by the Cued Go/No-Go Task. Data was collected from college students at Indiana University of Pennsylvania (n=462). Current findings indicated that students reported significantly less problematic alcohol use, alcohol use to cope, premeditation, school connectedness, as well as more stress and planning abilities than students prior to the pandemic. When comparing association among the variables, self-reported and performance-based EF were associated with resilience and school connectedness measures. Lowerclassman college students who endorsed severe stress with high problematic drinking reported less impulsive behaviors (i.e., more premeditation) than upperclassman students who endorsed severe stress with high problematic drinking. Additionally, Lowerclassman students who endorsed low problematic drinking rated themselves as possessing greater resilience than upperclassman students with high problematic drinking group. Also, upperclassmen who endorsed problematic alcohol use and severe stress made fewer omission errors than the rest of the sample after the acute stressor was presented. The current results demonstrated the changes in students' experiences during the pandemic associated with more stress than in previous cohorts, emphasizing the importance of building resources to increase students' resilience and connectedness to campus. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Supporting emotion regulation in individuals with ASD, ADHD and bipolar disorder through trauma-informed instruction and self-regulation strategies

Since the beginning of the COVID-19 pandemic, students have endured drastic changes in educational routines. Such disruptions can be especially challenging for students who struggle with executive functioning, self-regulation and emotion regulation, such as students with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and bipolar disorder. Using a framework of trauma-informed instruction, the authors supported classroom teachers in implementing sensory spaces for students with ASD, ADHD and bipolar disorder. The project included professional development and funding for teachers to develop, procure and offer sensory tools and strategies to assist students in recognising and managing emotions. The authors collected data on the effectiveness of the sensory supports, combining teacher surveys and student behaviour data. Results indicated increased teacher knowledge on trauma-informed instruction and use of sensory supports to promote executive functioning and self-regulation and decreased target behaviours in students based on structured observation and anecdotal teacher feedback.

The Impact of the COVID-19 Pandemic Quarantine on Adults with Autism Spectrum Disorders and Intellectual Disability: A Longitudinal Study.

The impact of the pandemic is being very significant psychologically, especially for people who were already vulnerable in these aspects, such as adults with Autism Spectrum Disorders (ASD) and Intellectual Disability (ID). A longitudinal analysis of motor aspects such as balance and gait, executive functions in daily life, severity of symptoms characteristic of autism, and degree of subjective well-being was performed in 53 adults with ASD and ID. A repeated measures ANOVA was performed and three measures were taken, the first in December 2019, the second in March 2020, and the last in July 2020. The results demonstrated a significant decrease in balance on the latter measure, along with a deterioration in well-being and ASD symptoms in the period of seclusion and an improvement in executive functions after seclusion.

Dual-Task-Based Music Therapy to Improve Executive Functioning of Elderly Patients with Early Stage Alzheimer's Disease: A Multiple Case Study.

Deficits in executive functioning are a common feature of Alzheimer's disease (AD) and result from impairment in the central executive system. As a result, elderly patients with early stage AD may require interventions that are more cognitively intense than traditional interventions. To address this need, in this multiple case study, we explored a dual-task-based music therapy intervention that involved drum playing and singing designed to induce attentional and motor controls. Three octogenarians diagnosed with early stage AD participated in 12 dual-task-based music therapy sessions over 6 weeks. Measures of executive functioning and the performance of a bimanual drum tapping task were evaluated before and after the intervention. Improvements in executive functioning were observed for participants A and C. After the intervention, reduced mean synchronization errors were found for the simultaneous tapping condition for all three participants. Although there was variability in the functional changes between participants, it is noteworthy that positive improvements in the elderly patients with early stage AD were obtained following dual-task-based music therapy. The results suggest that music therapy integrated into the dual-task paradigm can be an effective way to address degenerative cognitive deficits among elderly patients with early stage AD.

Individual Differences in Germ Spreading Behaviors Among Children With Attention-Deficit/Hyperactivity Disorder: The Role of Executive Functioning.

OBJECTIVE: Infectious diseases, such as coronavirus disease 2019 (COVID-19), are commonly transmitted by respiratory droplets and contact with contaminated surfaces. Individuals with attention-deficit/hyperactivity disorder (ADHD) are more likely to be infected with COVID-19 and experience more hospitalizations than individuals without ADHD. The current study investigated the role of ADHD symptomatology and executive functioning (EF) in germ spreading behavior frequency among young children with and without ADHD and parenting responses to these behaviors. METHODS: Participants included 53 children diagnosed with ADHD and 47 typically developing (TD) children between the ages of 4-5 years (76% male; Mage = 4.62; 86% Hispanic/Latinx). Parents and teachers reported on children's ADHD symptomatology and children completed three EF tasks. Germ spreading behavior frequency (direct contact of hand to face and toy in mouth) and parenting responses (verbal and nonverbal behaviors) were observed during a 5-min parent-child play situation. RESULTS: Negative binomial regression analyses indicated that both ADHD diagnostic status and poor metacognition predicted both higher rates of toy to mouth (ß = 1.94, p < .001; ß = 0.03, p = .004) and face touching frequency (ß = 0.60, p = .03; ß = 0.03, p = .004), respectively. Additionally, poor attention and worse cognitive flexibility only predicted higher rates of toy to mouth frequency (ß = 0.09, p < .001; ß = -0.04, p = .001), respectively. CONCLUSIONS: Young children with ADHD are at high risk for spreading germs via putting toys in their mouth and touching their face. Particularly, high levels of inattention and poor EF appear to be associated with higher rates of germ spreading behaviors.

Telephone-based Frontal Assessment Battery (t-FAB): standardization for the Italian population and clinical usability in neurological diseases.

BACKGROUND: Despite the relevance of telephone-based cognitive screening tests in clinical practice and research, no specific test assessing executive functioning is available. The present study aimed at standardizing and providing evidence of clinical usability for the Italian telephone-based Frontal Assessment Battery (t-FAB). METHODS: The t-FAB (ranging 0-12), comprising two subtests, has two versions: one requiring motor responses (t-FAB-M) and the other verbal responses (t-FAB-V). Three hundred and forty-six Italian healthy adults (HPs; 143 males; age range = 18-96 years; education range = 4-23 years) and 40 participants with neurological diseases were recruited. To HPs, the t-FAB was administered along with a set of telephone-based tests: MMSE, verbal fluency (VF), backward digit span (BDS). The in-person version of the FAB was administered to both HPs and clinical groups. Factorial structure, construct validity, inter-rater and test-retest reliability, t-FAB-M vs. t-FAB-V equivalence and diagnostic accuracy were assessed. Norms were derived via Equivalent Scores. RESULTS: In HPs, t-FAB measures yielded high inter-rater/test-retest reliability (ICC = .78-.94), were internally related (p ≤ .005) and underpinned by a single component, converging with the telephone-based MMSE, VF, BDS (p ≤ .0013). The two t-FAB versions were statistically equivalent in clinical groups (ps of both equivalence bounds < .001). Education predicted all t-FAB scores (p < .001), whereas age only the t-FAB-M score (p ≤ .004). t-FAB scores converge with the in-person FAB in HPs and clinical groups (rs = .43-.78). Both t-FAB versions were accurate in discriminating HPs from the clinical cohort (AUC = .73-.76). DISCUSSION: The t-FAB is a normed, valid, reliable and clinically usable telephone-based cognitive screening test to adopt in both clinical and research practice.

Cognitive phenotyping of post-infectious SARS-CoV-2 patients.

BACKGROUND: SARS-CoV-2 infection entails neuroinvasive, neuroinflammatory, and treatment-related features accounting for cognitive deficits in COVID-19-recovered patients. Although screening for such dysfunctions in this population is considered clinically relevant, contributions to cognitive phenotyping including premorbid and disease-related confounders are scarcely represented. This study thus aimed at describing the cognitive outcome at the function-/domain-level of post-infectious SARS-CoV-2 patients being already at risk (RCD +) or not (RCD -) for cognitive decline. METHODS: Fifty-four COVID-19-recovered individuals were classified as either RCD + or RCD - according to medical records. The Mini-Mental State Examination (MMSE), Addebrooke Cognitive Examination-Revised (ACE-R), Frontal Assessment Battery (FAB), and Attentive Matrices (AM) were administered (N = 54, 34, 28, and 28 patients, respectively). RESULTS: Prevalence of defective (cutoff = 24.89) MMSE scores was 24.3% in RCD + patients and 5.9% in the RCD - group. ACE-R-total below cutoff scores were less frequent (RCD + : 5.4%; RCD - : 5.9%). Abnormal performances at the FAB an AM were respectively detected in 18.9% and 8.1% of RCD + patients and 0% and 11.8% of the RCD - group. Within the ACE-R subtests, those assessing orientation, attention, and fluency were the most frequently impaired in both groups. Disease-related variables were mostly unassociated with cognitive measures. DISCUSSION: Both RCD + and RCD - COVID-19-recovered individuals might show cognitive deficits within the dysexecutive-inattentive and amnesic spectrum. Non-instrumental, executive/attentive dysfunctions are predominant in this population and can be detected by both screening and domain-specific psychometric tests-although the latter might be more sensitive in RCD - patients.

Executive functioning and purpose in life among emerging adults in college

Background: Executive functioning (EF) is a complex neurocognitive concept that grew from the field of neuropsychology and has been explored through various avenues. The most accepted theoretical organization of EF includes a three-factor model that is comprised of inhibition, updating, and shifting. The three-factor conceptualization can be measured through various objective EF neuropsychological assessments and self-reported levels of EF abilities. Goal-planning and organizing cognitive processes are another important facet of EF, as they involve self-regulation abilities. Individuals able to "regulate" themselves behaviorally and move towards goals tend to be more successful and move towards their purpose in life. A facet of positive psychology, purpose has demonstrated extensive benefits including overall general well-being. Additionally, purpose includes concepts that relate to higher-level processes that include relate to the three-factor model of EF: inhibition, updating, and shifting. Despite the commonalities listed between EF and purpose in life, examination of a possible relationship between the two concepts has yet to be undertaken. Methods: To explore the relationship between EF and purpose in life, online self-report measures were administered including the Barkley Deficits in Executive Functioning Scale, Short Form (BDEFS-SF), the Claremont Purpose Scale (CPS), the Short Self-Regulation Questionnaire (SSRQ), the Meaning in Life (MLQ), and the Valued Living Questionnaire (VLQ). Objective measures of EF utilizing the Delis-Kaplan Executive Functioning System (D-KEFS) were also obtained through in-lab participation. Results: Pearson r correlations analyses were calculated using BDEFS-SF summary scores and CPS total scores, yielding a significant negative correlation between EF deficits and total perceived purpose. This was followed up by a simple linear regression analyses to further determine the nature and extent of the relationship between the BDEFS-SF subscales on CPS total scores. Resulted indicated less deficits in Self-Management to Time significantly predicted participants' perceived purpose in life as did less deficits in Self-Motivation. Due to COVID-19, only a small number of in-lab participant data was collected, yielding non-significant regression model of D-KEFS subtests on total CPS scores. Discussion: The present findings suggest that a relationship with EF capabilities and purpose in life, such that better EF capabilities were associated with higher levels of perceived purpose in life. Thus, further examination of the overlap between the of neuropsychological and positive psychology concepts and how both can be utilized to inform clinical interventions is warranted. Due to COVID-19 restrictions during the administration of the present study, various limitations regarding objective measure data impacted some results. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The crisis of COVID-19 and opportunities for reimagining education

Our argument in this brief contribution is that COVID-19 has brought the experience of education to a crisis with respect to its practices and the theories that inform it. The practice crisis is about the glaring inequalities in peoples’ access to education. The theory crisis is about how we learn. Our contention is that our dominant cohort learning approaches fail to address the many differences children bring to the learning task. In response we make two key moves: the first is to restore the centrality of cognition in all processes of teaching and learning, and the second is to situate cognition in its full biopsychosocial complexity. With respect to the first move we begin our discussion of teaching and learning with a focus on cognition and particularly on its executive function component. We provide the explanation of what it is, and with that, we move to our second to show the importance of new learnings about epigenetics that explain the significance of the relationship between the biological and the social to the cognitive process. © 2021 Ediciones Universidad de Salamanca. All right reserved.

The impact of work-related stress on the cognition domain of executive functioning of health care workers during the COVID-19 pandemic.

PURPOSE: The current study addressed work-related stress and burnout experienced by health care workers (HCWs) in Cairo University isolation hospital and its impact on the cognitive domain of their executive functioning. METHODS: Arabic validated questionnaires of Beverly Potter for sources of work-related burnout and Maslach Burnout Inventory Human Services Survey for evaluation of burnout degree of 81 HCWs were used. Wisconsin Card Sorting Test was used to examine the HCWs cognitive executive functioning during hospital work and 2 weeks after home isolation. RESULTS: A high degree of work-related stress was evident by a high score on Beverly questionnaire with a mean ± SD of (132.08 ± 12.573). A high degree of burnout was marked with a mean ± SD of (28.48 ± 6.622) for Emotional Exhaustion module, (31.85 ± 5.439) Personal Achievement, and (17.52 ± 6.707) Depersonalization. Health care workers experienced impairment of executive functioning in the form of increased total errors of Wisconsin Card Sorting Test during hospital shifts compared to 2 weeks after. There is a positive significant correlation between work-related stress level and Maslach Burnout Inventory and the total errors of Wisconsin Card Sorting Test results during the hospital stay (p = < 0.001), as well as 2 weeks after (p = < 0.001).This cognitive decline manifested in increased errors during HCWs' clinical work. CONCLUSIONS: Health care workers on the front line experienced a high degree of work-related stress in addition to burnout in the form of Emotional Exhaustion, Depersonalization, and reduced Personal Achievement. They also suffered from impaired cognitive executive functioning due to such stressful exposure.

Childhood Cancer Survivors and Distance Education Challenges: Lessons Learned From the COVID-19 Pandemic.

OBJECTIVE: Pediatric cancer survivors have historically struggled to receive adequate educational supports. In Spring 2020, the COVID-19 pandemic forced an emergency switch from traditional in-person education models to distance education, but little information is available regarding experiences of pediatric survivors' coping with schooling since that time. METHODS: This article presents exploratory mixed methods findings from a quality improvement project including qualitative interviews and a quantitative survey conducted with parents of pediatric oncology survivors identified through neuropsychological assessment, and the use of school-based services as having educationally relevant neurocognitive impacts of disease or treatment. The interviews explored experiences of education and instructional delivery during the COVID-19 school closures in spring of 2020 and the beginning of the 2020-2021 school year and served as the foundation for a quantitative survey to determine the generalizability of findings. RESULTS: Qualitative interviews highlighted 3 emergent themes regarding the shared experiences of distance schooling for children with cancer during the COVID-19 school closures: (a) attention, (b) mental health, and (c) access to instruction. A follow-up quantitative survey supported the qualitative findings and their generalizability to the schooling experiences of other children with cancer during the pandemic. CONCLUSION: This article describes and explores each theme and offers suggestions for pediatric supports and changes to provider service delivery (including weblinks to access project-developed resources) as a result of ongoing pandemic-related schooling needs.

Implications of the Online Teaching Model Derived from the COVID-19 Lockdown Situation for Anxiety and Executive Functioning in Spanish Children and Adolescents.

Given the seriousness of the existing situation regarding the mental health of children and adolescents relating to the confinement period imposed due to COVID-19, we conducted this study to describe the effects of the confinement on state anxiety and executive functioning dimensions in a period of online educational modality. A sample of 953 children and adolescents was assessed. A sociodemographic questionnaire, the State Anxiety Inventory for Children (STAIC), and the Behavioral Evaluation of Executive Function (BRIEF-2) scale were applied. The analysis of the results indicates that 68.8% of children and adolescents presented medium-high levels of anxiety. Regarding sex, females showed higher levels of anxiety and worse levels of executive functioning. Although the group aged 11 to 18 years showed methodologically higher state anxiety (p = 0.041) than the group aged 6 to 10 years, the difference was not clinically relevant (δ = -0.113). The state anxiety variable was also correlated positively and significantly to the three executive functioning dimensions explored. In conclusion, it seems evident that COVID-19 lockdowns could have psychological and emotional effects on children and adolescents.

Parental Distress and Perception of Children's Executive Functioning after the First COVID-19 Lockdown in Italy.

The spread of the novel coronavirus (COVID-19), and the consequential first italian lockdown to minimize viral transmission, have resulted in many significant changes in the every-day lives of families, with an increased risk of parental burnout. This study explores the impact of the first COVID-19 lockdown in Italy on parental distress and parental perceptions of children's executive functions (EFs). Participants were 308 Italian parents with children between 4 and 17 years of age; they were recruited through online advertisements on websites and social media, and they were given an online survey. The measures were: the balance between risks and resources (BR2) and the executive functioning self-report (EF). Findings of the study suggest that the most distressed parents perceived their children as less competent in EF, highlighting a cognitive fragility on attention, memory, and self-regulation (Pearson correlation coefficient, p < 0.05); significant differences were found between parents of children exhibiting typical and atypical patterns of development (ANOVA, p < 0.05). The study reinforces the need to provide families with psychological aid to support parental competence in restrictive lockdown conditions.

The Impact of COVID-19 on Cognitive Development and Executive Functioning in Adolescents: A First Exploratory Investigation.

BACKGROUND: The rapid expansion and severity of the COVID-19 contagion has had negative physical and psychological health implications for millions of people around the world, but even more so among children and adolescents. Given the severity of the situation and the small number of studies on the direct influence of viral infection on the cognitive development within adolescents, the present study aims at understanding the consequences of contracting the virus and being hospitalized in relation to cognitive functioning, in particular, for executive functioning, among adolescents. METHODS: To all subjects included in the sample, divided into four groups based on the severity of the COVID-19 infection, were administered the WISC-IV in order to evaluate the global cognitive functioning, and subsequently, the subtests Courses and Tower of London (ToL), both part of the BVN 12-18, were administered for the evaluation of executive operation. RESULTS: Our analyses showed that between subjects who did not contract the viral infection and those who contracted it in an asymptomatic form, there are no significant differences in cognitive functioning, but only in executive functioning. Furthermore, in both hospitalized and non-hospitalized subjects, we found lower scores especially for WM skills, while IQ scores are in a medium range. CONCLUSION: the present study shows that contracting the viral infection and, thus, being hospitalized, caused greater problems and difficulties as compared to those who were not hospitalized, impacting global cognitive (and executive) functioning, especially the WM. We believe that these results could allow an early detection of alterations in cognitive and executive functioning, a fundamental aspect of the interventions that occur in evolutionary phases such as those related to pre-adolescence, allowing, therefore, the activation of functional recovery pathways in a short time.

Neurocognitive deficits in severe COVID-19 infection: Case series and proposed model.

Objective: To date, very few studies investigating neurocognitive deficits in COVID-19 have been published. This case series addresses cognition in post-COVID-19 patient by describing three patients in acute rehabilitation to inform a model of cognitive sequelae of COVID-19. Methods: Three English-speaking inpatients with severe symptoms and long-term intensive care unit (ICU) treatment are described. All patients had a premorbid history of hypertension and hyperlipidemia and experienced delirium and hypoxemia when hospitalized. Patient 1 is a 62-year-old male with 15 years of education with additional history of obstructive sleep apnea and type 2 diabetes. Patient 2 is a 73-year-old female with 12 years of education with a premorbid medical history of alcohol use disorder and Guillain-Barre syndrome. Patient 3 is a 75-year-old male with 14 years of education. No patients had premorbid psychiatric histories. Results: The three patients demonstrated deficits on formal neuropsychological testing, particularly with encoding and verbal fluency. Memory measures improved with a more structured story memory task compared to a less-structured verbal list-learning task, suggesting executive dysfunction impacted learning. None of the patients demonstrated rapid forgetting of information. Two patients endorsed new depressive and/or anxiety symptoms. Conclusions: The results suggest evidence for neurocognitive deficits after severe COVID-19 infection, particularly in encoding and verbal fluency. These results were interpreted with caution given the limited number of patients and the telephone-based battery. The specific mechanism that caused these cognitive deficits in these individuals remains unclear. A proposed three-stage model of cognitive dysfunction is described to help guide future research.