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Executive Function Documentation

Procedure

The study involves several segments, the procedures for which are addressed separately here. All participants will complete parts 2 and 3 during two separate time-points, while participants who enroll in the first half of the project period will be able to complete an additional third session (also comprised of parts 2 and 3 below).

  1. Following pre-screening subjects will receive a reminder call 1 week and 1 day before the appointment, as well as a reminder email or letter.

  2. Standard Psychiatric and Cognitive Assessment Assessment: All subjects will receive detailed assessments to comprehensively evaluate EF capacity in the context of psychiatric diagnosis and document functioning in other cognitive domains. Assessment of youths and collateral information from parents will take place in a single 3-5 hour visit that will be performed within 1 month of neuroimaging. Informed written consent will be obtained from the parent/guardian of the participant, and assent will be obtained from the participant. We will be collecting consent and administering a portion of study procedures electronically, over the phone, or using BlueJeans or similar HIPAA-compliant, IRB and University approved teleconferencing systems.
    • Assessment of EF using a battery of tasks
    • Multi-domain assessment of cognition: Beyond measures of EF, all participants will complete the Penn CNB.
    • Clinical diagnostic assessment: All subjects will receive a detailed diagnostic assessment from highly-trained assessors using a computerized version of the K-SADS interview. As in our prior work, prodromal symptoms of psychosis will be assessed using Structured Interview for Prodromal Symptoms. Furthermore, the Scale of Prodromal Symptoms (SOPS) will be administered along with the SIPS; the SOPS rates the severity of prodromal, psychotic, and other symptoms occurring within the past 6 months.
  3. Neuroimaging Protocol The imaging visit lasts approximately 4-5 hours. All subjects will undergo longitudinal neuroimaging as part of this study. Images will be acquired in a one-hour session using a research-dedicated 3T Siemens Prisma Scanner. All sequences will be harmonized with the landmark Adolescent Brain Cognitive Development (ABCD) study, to facilitate data pooling and sharing.
    • Sequences acquired will include T1 and T2 sequences to assess brain structure, diffusion imaging for structural tractography, and fMRI to measure EF activation, functional connectivity, and task-based functional dynamics. As in ABCD, intrinsic connectivity scanning will be broken into four brief (~5 min) runs to reduce in-scanner motion.
    • Prior to scanning, a practice task may be conducted inside a mock scanner environment, which acclimatizes participants to the environment and minimizes novelty effects. Preparation for MRI: A brief (5 min) practice task will be conducted inside a decommissioned MRI scanner as part of a mock-scanning session in order to ensure all subjects understand and can perform the task, as well as to acclimatize the subjects, reducing novelty and anxiety responses inside the scanner. Participants will then be prepared for scanning by the investigator and the MRI technician. After assessing state anxiety and mood symptoms, subjects will be placed supine in the scanner, wearing earplugs to muffle noise.
    • Structural and functional scans will be obtained in a single session on a clinically-approved 3 Tesla Siemens Prisma (Erlangen, Germany) scanner, equipped with 80mT/m gradients and 200 mT/m/s slew-rates. RF transmission will use a quadrature body-coil, and reception will use a Siemens receive-only 64-channel head coil. The total time in the scanner will be approximately 1 hour.

  4. In addition to scanning, participants may also complete self-report questionnaires and decision-making tasks, outlined below. We will be administering a portion these study procedures electronically, over the phone, or using BlueJeans or similar HIPAA-compliant, IRB and University approved teleconferencing systems.

  5. There will also be additional symptom assessments and decision making batteries administered.