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Karel M.J.,Psychology Service | Karel M.J.,Harvard University | Gatz M.,University of Southern California | Smyer M.A.,Bucknell University
American Psychologist

Until relatively recently, most psychologists have had limited professional involvement with older adults. With the baby boomers starting to turn 65 years old in 2011, sheer numbers of older adults will continue to increase. About 1 in 5 older adults has a mental disorder, such as dementia. Their needs for mental and behavioral health services are not now adequately met, and the decade ahead will require an approximate doubling of the current level of psychologists' time with older adults. Public policy in the coming decade will face tensions between cost containment and facilitation of integrated models of care. Most older adults who access mental health services do so in primary care settings, where interdisciplinary, collaborative models of care have been found to be quite effective. To meet the needs of the aging population, psychologists need to increase awareness of competencies for geropsychology practice and knowledge regarding dementia diagnosis, screening, and services. Opportunities for psychological practice are anticipated to grow in primary care, dementia and family caregiving services, decision-making-capacity evaluation, and end-of-life care. Aging is an aspect of diversity that can be integrated into psychology education across levels of training. Policy advocacy for geropsychology clinical services, education, and research remains critical. Psychologists have much to offer an aging society. © 2011 American Psychological Association. Source

Alosco M.L.,Psychology Service
Journal of Head Trauma Rehabilitation

OBJECTIVE:: To examine the temporal consistency of self-reported deployment-related traumatic brain injury (TBI) and its association with posttraumatic stress disorder (PTSD) symptom severity. SETTING:: In-person interviews at US Army installations (postdeployment); phone interviews (long-term follow-up). PARTICIPANTS:: A total of 378 US Army soldiers and veterans deployed to Iraq; 14.3% (n = 54) reported TBI with loss of consciousness during an index deployment. DESIGN:: Participants were evaluated after returning from deployment and again 5 to 9 years later. MAIN MEASURES:: Temporal consistency of TBI endorsement based on TBI screening interviews; PTSD Checklist, Civilian Version. RESULTS:: The concordance of deployment-related TBI endorsement from the postdeployment to long-term follow-up assessment was moderate (κ = 0.53). Of the 54 participants reporting (predominantly mild) TBI occurring during an index deployment, 32 endorsed TBI inconsistently over time. More severe PTSD symptoms at postdeployment assessment were independently associated with discordant reporting (P = .0004); each 10-point increase in PCL scores increasing odds of discordance by 69% (odds ratio = 1.69; 95% confidence interval, 1.26-2.26). CONCLUSIONS:: Deployment-related TBI may not be reported reliably over time, particularly among war-zone veterans with greater PTSD symptoms. Results of screening evaluations for TBI history should be viewed with caution in the context of PTSD symptom history. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source

Bankoff S.M.,Psychology Service | Pantalone D.W.,University of Massachusetts Boston
Eating Disorders

Most disordered eating research has focused on White, heterosexual women. More empirical work is needed to better understand disordered eating among women of diverse backgrounds. Given evidence of disparities between heterosexual and sexual minority (i.e., non-heterosexual) women in other health behaviors (e.g., tobacco use) and outcomes (e.g., cardiovascular disease), it appears important to study disordered eating behaviors among sexual minority women. In this article, we review the extant literature on disordered eating behaviors in women across sexual orientations, with a focus on research examining potential mechanisms of disparities in disordered eating, including awareness and internalization of sociocultural norms. Copyright © Taylor & Francis Group, LLC. Source

Donders J.,Psychology Service | Levitt T.,Independent Practice
Archives of Clinical Neuropsychology

The performance of 54 patients with complicated mild-severe traumatic brain injury (TBI) was evaluated on the Attention, Executive Functions, and Memory modules of the Neuropsychological Assessment Battery (NAB) and compared with that of 54 demographically matched healthy controls. All three NAB indices demonstrated statistically significant group differences and negative covariances with the duration of coma, with large effect sizes. The Numbers and Letters and Mazes subtests had the most consistent evidence for sensitivity to brain injury. The findings provide preliminary support for the criterion validity of the NAB in the assessment of patients with complicated mild-severe TBI. © The Author 2012. Published by Oxford University Press. All rights reserved. Source

Leininger S.,Psychology Service | Skeel R.,Central Michigan University
Archives of Clinical Neuropsychology

Although increased anxiety and cortisol reactivity can disrupt neural activity and impact cognition, little research has evaluated associations between anxiety, cortisol, and performance on neuropsychological instruments. The current study investigated the relationship between exogenous salivary cortisol activity and self-report state anxiety on measures tapping a variety of cognitive domains. Fifty-eight male participants were randomly assigned to either a control (no stress induction) or an experimental condition simulating testing anxiety. Self-report state anxiety measures and saliva samples were jointly collected on three occasions. The experimental group generally performed worse than controls on declarative memory and working memory tests. Cortisol and self-report anxiety were not correlated. Inverse relationships were demonstrated between self-report anxiety and neuropsychological test scores. Baseline levels of cortisol at session arrival were positively associated with facilitative memory effects, though there was little association between changes in cortisol and cognitive performance. This study highlights the importance of considering the impact of anxiety during neuropsychological evaluations. © The Author 2012. Source

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