Older adults consistently show elevated rates of false recognition of new items that are related to studied items. This finding has been largely attributed to a greater tendency for older adults to rely on conceptual gist during memory recognition tasks. However, perceptual factors may also be implicated considering that related items are not only conceptually but also perceptually similar. While some findings do suggest that age-related increases in false recognitions can be driven by perceptual factors, little is known about the nature and circumstances under which these factors operate. To address this gap, we measured basic visual ability as well as false recognition for four different image categories (upright faces, inverted faces, chairs, houses) in younger ( n = 34) and older ( n = 34) adults. Each image category represented different levels of variability in perceptual similarity and pre-experimental exposure. Perceptual similarity was objectively defined on the basis of the low-level properties of the images. We found evidence that perceptual similarity can contribute to elevated rates of false recognition in older adults. Our results also suggest that declines in basic visual abilities influence elevated false recognition in older adults for perceptually similar but not perceptually dissimilar items. We conclude that both perceptual and conceptual similarity can drive age-related differences in false recognition.

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Polysubstance dependence has been associated with many neurocognitive impairments. The present study explored one of these deficits, namely conditional reasoning, using the Wason selection task. In healthy individuals, social contract and precautionary content improve conditional reasoning performance compared with descriptive or abstract content. Twenty-two recently detoxified polysubstance-dependent patients were compared with 22 controls matched for sex, age, and education level on their performance on the Wason selection task across problems involving social contract, precautionary, and descriptive conditional rules, controlling for depression, anxiety levels, and verbal intelligence. Conditional reasoning on descriptive and social contract rules was severely impaired in polysubstance-dependent patients. Precautionary reasoning was also impaired, but to a lesser degree than the other modalities of conditional reasoning. These results may reflect a toxic effect of chronic multiple-drug consumption on the prefrontal areas of the brain. Alternatively, conditional reasoning difficulties could be present, at least partially, before polysubstance dependence onset. This population may have difficulties properly understanding social contracts in real-life settings, suggesting a potential target for clinical intervention.

BACKGROUND A third of adolescents experiencing a concussion will suffer from persistent post-concussion symptoms lasting a month or beyond. The ability to cope with concussion symptoms, regulate emotions, and manage stress is an important determinant of risk for prolonged symptoms. Early psychological interventions, such as mindfulness-based interventions, might improve concussion recovery. OBJECTIVE This open-label mixed-methods pilot study assessed the acceptability and credibility of a mindfulness-based intervention delivered through a digital therapeutic (DTx; therapeutic smartphone app) for pediatric concussion. METHODS Participants aged 12-18 years were recruited from an emergency department within 48 hours of a concussion (acute cohort) or from a tertiary care clinic at least 1 month post-concussion (persistent symptom cohort). Participants completed a novel 4-week mindfulness-based intervention, for 10-15 min/day, at a minimum of 4 days/week. At 2 weeks post-concussion, participants completed a credibility questionnaire. At 4 weeks, participants completed questionnaires assessing satisfaction, usability, and working alliance, as well as a semi-structured phone interview. RESULTS 10 participants completed the study outcomes, including 7 acute (5 females; median [IQR] age=14.73 [13.94,16.94] years and 3 persistent symptom patients (2 females; median [IQR] age=17.62 [17.48,17.86] years). Across cohorts, half-way through the intervention, the treatment expectation was moderate (median=6.00 [3.58,7.75], maximum possible=9.00). Moreover, the intervention was perceived as credible (median=6.50 [6.83,8.75], maximum possible=9.00). At 4 weeks, the DTx was considered usable (median=70.00 [55.00,82.50], maximum possible=100.00). Participants rated their satisfaction with the DTx (median=27.00 [24.50,29.50], maximum possible=32.00) and the working alliance with the digital mindfulness guides (median=3.92 [3.38-4.33], maximum possible=5.00) as high. Four themes were identified from the qualitative data: 1) positive attributes (including accessibility, ease of use, perceived effectiveness, variety of features, and meditation guides); 2) negative attributes (technical issues that acted as a barrier to use, and sounds and lights that were triggering headaches); 3) ideas for modifications; and 4) technical issues. CONCLUSIONS Adolescents were very satisfied with a mindfulness-based intervention delivered via a smartphone app and considered it to be usable and credible. Results inform modifications to the DTx, instructions, and mindfulness intervention, and potential ways to increase adherence by leveraging positive attributes. A randomized control trial will assess the effectiveness of the DTx to decrease the risk of persistent symptoms and reduce the symptom burden following pediatric concussion. The present mixed-methods study and the iterative approach to intervention design we are using will ensure better translation and impact of interventions for adolescents with concussions.

This study investigated associations between psychological resilience and characteristics of white matter microstructure in pediatric concussion. This is a case control study and a planned substudy of a larger randomized controlled trial. Children with an acute concussion or orthopedic injury were recruited from the emergency department. Participants completed both the Connor–Davidson Resilience Scale 10 and an MRI at 72 h and 4‐weeks post‐injury. The association between resiliency and fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) at both timepoints were examined. We examined whether these associations were moderated by group. The association between resiliency captured at 72 h and diffusion tensor imaging metrics at 4 weeks was also investigated. Clusters were extracted using a significance threshold of threshold‐free cluster enhancement corrected p < .05. A total of 66 children with concussion (median (IQR) age = 12.88 (IQR: 11.80–14.36); 47% female) and 29 children with orthopedic‐injury (median (IQR) age = 12.49 (IQR: 11.18–14.01); 41% female) were included. A negative correlation was identified in the concussion group between 72 h resilience and 72 h FA. Meanwhile, positive correlations were identified in the concussion group with concussion between 72 h resilience and both 72 h MD and 72 h RD. These findings suggest that 72 h resilience is associated with white matter microstructure of the forceps minor, superior longitudinal fasciculus, and anterior thalamic radiation at 72 h post‐concussion. Resilience seems to be associated with neural integrity only in the acute phase of concussion and thus may be considered when researching concussion recovery.