Clinical Neuropsychology Lab
Research & Initiatives
Neuropsychology/Geropsychology
My research is focused on the early detection of individuals at risk for incident Alzheimer's disease, with an emphasis on the development of sensitive subjective and objective cognitive tools. In recent years increased attention has been paid to nondepressed, healthy older adults who present with subjective cognitive decline (SCD) despite intact neuropsychological functioning. These individuals show biomarker abnormalities consistent with Alzheimer’s disease pathology such as gray matter volume loss, cerebral hypometabolism, and amyloid deposition, are at increased risk for future cognitive decline, Thus, SCD in otherwise healthy older adults may indicate underlying neurodegenerative changes and could provide an earlier therapeutic opportunity than mild cognitive impairment. However, research on SCD lacks a standardized definition and approach to assessment. This shortcoming severely limits the comparability of research findings across settings and studies. Currently, I am working to refine SCD assessment approaches. For example, I am a member of an international working group that seeks to establish a conceptual framework for SCD research. We are pooling data across international aging studies to derive core self-report questions, related to memory and other cognitive domains, most strongly associated with AD biomarkers and cognitive decline in nondemented older adults. A related area of investigation considers the relative benefits of self- and informant reports of cognitive decline. Given limited time for screening of clinical patients or research participants, preliminary results from our lab suggest that administration of an informant questionnaire may initially signal the need for further neuropsychological evaluation.
Assessment Tools
Our research addresses assessment and measurement issues in cognitive aging and neuropsychology through the development and validation of instruments that can be utilized in diverse clinical and research settings. These projects inform research on preclinical dementia in terms of the selection of cognitive measures best able to capture subtle cognitive changes. A particular area of interest relates to the assessment of judgment ability. With a dramatic increase in the aging population, there is a critical need to improve the detection of diminished cognitive capacity and increase protection of older adults from financial exploitation and other abuses. Judgment is an important aspect of executive functioning that is critical to many aspects of real-world functioning among older adults. However, available methods to assess judgment, lack robust psychometric properties, ecological validity, alternate and informant forms, and validation among diverse participant samples. To address these concerns, we developed and validated the Test of Practical Judgment (TOP-J), which is used by researchers and clinicians across the U.S. and abroad. Together with collaborators (C. Quinn, N. Pare, M. Garlinghouse, C. Nester, and others), we are working to update normative data for the TOP-J with a larger and more diverse sample. Additionally, we are validating an alternate form of the TOP-J, taking into account recent feedback from neuropsychologists. We are also developing and validating an informant version of the TOP-J, which will allow neuropsychologists to assess the same areas of judgment, but from the perspective of a caregiver. This line of research aims to improve the ability to detect and characterize emerging judgment impairments in older adults with subtle cognitive decline through dementia, to assess risk, and to devise interventions for safe and independent living in older adulthood.
Mental Health Literacy Project
With generous support from the JCK Foundation, a diverse team of researchers at Brooklyn College/CUNY, led by Professors Rona Miles and Laura Rabin, is studying mental health literacy among undergraduate students. Specifically, the project investigates students’ knowledge of psychological disorders and available treatment options and identifies perceived barriers to help-seeking behavior. To address these goals, we recently developed and validated an 18-item mental health literacy questionnaire with three alternate forms—and we are currently investigating the variables most predictive of mental health literacy among undergraduates from varied academic majors. Study results will provide a starting point for larger discussion about how to decrease the stigma associated with mental health issues. Long-term goals include the development of educational and interventional programming for students and faculty to reduce the prevalence and severity of psychological disorders among this vulnerable population.
Educational Research
Work with diverse college students has spurred interest in research related to innovative teaching approaches and psychological and behavioral predictors of academic success. Ongoing projects investigate: (1) academic, psychological, and demographic variables that predict success in undergraduate psychology statistics; (2) benefits of peer-mentoring for improving outcomes in psychology statistics; (3) psychometric properties of a novel academic self-efficacy scale; (4) barriers to success in organic chemistry and factors that predict success in passing the course; (5) benefits of gamification of an undergraduate psychology statistics laboratory course; and (6) the utility of a newly developed test of basic math skills for use with undergraduate statistics students. For this latter study (#6), we developed and validated a 30-item, objective measure of mathematical skills—i.e., the Math Assessment for College Students, MACS. We subsequently measured predictors of overall exam grades in undergraduate statistics using a broader set of explanatory variables than have been used in previous studies (self-reported self-efficacy/outcome expectancy, help-seeking, and procrastination, and demographic variables of gender, year in school, race/ethnicity, and transfer status). The variable with the greatest predictive validity, by far, was basic mathematics skills. These exciting results suggest that improved mastery of elementary mathematics skills such as arithmetic and algebra may directly impact student outcomes in this notoriously difficult class. Instructors should consider obtaining an estimate of students’ mathematics skill, early in the semester, to identify the concepts with which students struggle—then try to improve these skills. Along with my collaborators (A. Krishnan, R. Miles, J. Drake, R. Bergdoll), a future goal is to develop an intervention to improve basic mathematics skills. In addition to directly improving course performance, we hope that such an intervention will indirectly benefit learning by reducing fear and anxiety about statistics, while enhancing students’ confidence and motivation to succeed.
National Science Foundation
I am proud to be the Principal Investigator on a National Science Foundation Research Experiences for Undergraduates (REU) grant. The overall objective of the psychology and neuroscience site at Brooklyn College is to immerse diverse students in innovative research on clinical, cognitive, and behavioral neuroscience. We meet this objective by engaging undergraduates at ethnic-minority serving, public two- and four-year institutions in the New York metropolitan area in intensive, semester-long mentored research and professional development experiences. Recruitment targets students from groups historically underrepresented in the STEM sciences, including racial/ethnic minorities, first-generation college students, women and veterans, and those who have experienced educational, economic, or personal disadvantage that impedes their transition to the next stage of a science career. Additionally, our program includes a Research Experiences for Teachers (RET) component. Each year, we select two local junior and/or high school teachers for mentored laboratory experiences, coursework in research methods, and professional development opportunities in psychology and neuroscience. Through these efforts we aim to enhance teachers’ scientific literacy and competency and raise the level of science education in local high schools.
Neuropsychological Test Usage
My survey work aims to document trends in neuropsychological test usage with the larger goals of informing battery construction and stimulating discussion about critical, emerging issues in neuropsychological assessment. In my early years at Brooklyn College, I published survey work that constituted my dissertation. The first of these papers, which reported on test usage patterns of clinical neuropsychologists with regard to memory, attention, and executive functions, represented the largest and most comprehensive test usage survey conducted within the field of clinical neuropsychology—and was widely cited. In 2011 my colleagues and I conducted a 10-year follow-up to this study. We expanded the original questionnaire to include additional cognitive domains and to address practice-related issues important to contemporary clinical neuropsychology. These results have been published in a series of papers and book chapters on topics including neuropsychologists’: assessment of ethnic minorities, utilization of computerized instruments, utilization of tests within specific cognitive domains (recently highlighted by the SCN Science Advisory Committee), forensic assessment practices, use of paid psychometrists, and assessment of athletes as part of sports programs.