Prospective memory in early and established psychosis: An Indian perspective

Individuals affected by psychosis often have deficits in several neurocognitive functions. Prospective memory (PM), the ability to remember to do things, is crucial for activities of daily living, social and occupational functioning, but very few studies have attempted to examine this domain of functioning in people with psychosis, particularly in India. A total of 71 patients with psychosis, (both early and established psychosis), and 140 age, gender and education-matched healthy controls were assessed using the Positive and Negative Symptom Scale, Hospital Anxiety and Depression scale, and Addenbrooke's Cognitive Examination. PM was assessed using the Cambridge Prospective Memory Test and the Prospective and Retrospective Memory Questionnaire (PRMQ). Group differences were evaluated using Mann–Whitney U-tests. Significantly greater cognitive deficits, higher anxiety and depression were evident in the psychosis group compared with controls. The psychosis group performed significantly poorer on both time- and event-based tests in CAMPROMPT than controls. These differences remained when controlling for age, education, general cognitive functioning and mood. The subjective measure of PM (PRMQ) did not differentiate the two groups. The PM performance of early and established psychosis patients was similar. Comparisons with cross-cultural data (PRMQ UK norms and CAMPROMPT and PRMQ Chinese data) revealed important differences in PM performance. Individuals with psychosis have significant deficits in both time- and event-based PM. CAMPROMPT emerged as a more sensitive PM measure compared with PRMQ. Results from cross-cultural comparisons underscore the need for cultural contextualization of assessments.     

The role of neuropsychology in UK pediatric HIV care: Relevance to clinical practice and research

There has been a dramatic improvement in the survival of children with perinatally-acquired HIV (PHIV) following the introduction of effective treatment in 1990s. The care for children living with PHIV is now focused on more accurately understanding the effects of both HIV and HIV treatment on the developing body and brain. An evaluation of current HIV neuroimaging, and neurocognitive research, when combined with clinical experience in the area of HIV, could help to inform United Kingdom (UK) PHIV service provision. This paper argues that an understanding from a neuropsychological perspective will help these young people to optimize their health, quality of life, and future functioning. The aim of the paper is to bring together research and clinical understanding of HIV and its treatment effects on the developing brain, together with an understanding of other potential neurological risk factors. It is argued here that there is a need for targeted neuropsychology assessment and preventative interventions, supported by clinical and preliminary research on the neurocognitive effects of HIV and its treatments.     

The effects of HIV disease and older age on laboratory-based,naturalistic, and self-perceived symptoms of prospective memory: does retrieval cue type and delay interval matter?

There is a rising prevalence of older HIV+ adults who are at risk of deficits in higher order neurocognitive functions and associated problems in everyday functioning. The current study applied multiprocess theory to examine the effects of HIV and aging on measures of laboratory-based, naturalistic, and self-perceived symptoms of prospective memory (PM). Participants included 125 Younger (48 with HIV, age = 32 ± 4.6 years) and 189 Older (112 with HIV, age = 56 ± 4.9 years) adults. Controlling for global neurocognitive functioning, mood, and other demographics, older age and HIV had independent effects on long-delay time-based PM in the laboratory, whereas on a naturalistic PM task older HIV? adults performed better than older HIV+ adults and younger persons. In line with the naturalistic findings, older age, but not HIV, was associated with a relative sparing of self-perceived PM failures in daily life across longer delay self-cued intervals. Findings suggest that, even in relatively younger aging cohorts, the effects of HIV and older age on PM can vary across PM delay intervals by the strategic demands of the retrieval cue type, are expressed differently in the laboratory and in daily life, and are independent of other higher order neurocognitive functions (e.g., retrospective memory).     

Evaluation of executive functions in children and adolescents with familial Mediterranean fever

The aim of the present study was to investigate neuropsychological test performance in children and adolescents with familial Mediterranean fever (FMF). A total of 88 children and adolescents aged 8 to 17 years were included, 52 with FMF and 36 healthy controls. After the participants were administered the Children Depression Inventory (CDI) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), they completed the battery tests of the Central Nervous System Vital Signs (CNSVS), a neurocognitive test battery, via computer. The battery calculates seven domain scores (Memory, Psychomotor Speed, Processing Speed, Reaction Time, Complex Attention, Executive Function, and Cognitive Flexibility) and a summary score (Neurocognition Index [NCI]). A statistically significant difference between the FMF and control groups was found in six out of seven domains, where the scores of the participants with FMF were found to be significantly lower than those of the control participants (p < .05). Although the mean Reaction Time score of the participants with FMF was found to be lower than that of the control participants, the finding was not statistically significant (p > .05). The mean CDI and SCARED scores of the participants with FMF were found to be significantly higher than those of the control participants (p < .05). Low scores in the Processing Speed and Psychomotor Speed domains of the CNSVS were significantly correlated with higher SCARED scores (r = ?.37, p = .01). Impaired cognitive functions should be taken into consideration in children and adolescents with FMF when assessing and managing this population.     

Attention and executive functioning profiles in children following perinatal arterial ischemic stroke

Perinatal arterial ischemic stroke (PAIS) is a form of childhood stroke; the majority of those affected experience neurologic sequelae, including motor, language and neurocognitive impairments. This study examines the attention and executive functioning (EF) profiles of children following PAIS, as well as the impact of age and sex. In this single-center cross-sectional study, 40 children aged 3 to 16 years (median age 7.2 years; 58% male) who have suffered a PAIS underwent a comprehensive neuropsychological battery to assess attention and EF. Parents completed behavioral questionnaires regarding real-world functioning. Composite scores were calculated for seven attention and EF domains (Attention, Working Memory, Verbal Retrieval, Inhibitory Control, Flexibility/Shifting, Planning/Organization, and Processing Speed). The results for all measured domains of attention and EF are significantly lower in the participants compared to the normative samples (p < .001), with the exception of Working Memory. However, increasing difficulty with Working Memory is associated with developing age. Older age at time of testing is also associated with a higher incidence of clinically-elevated attention deficit hyperactivity disorder (ADHD) symptoms. Sex is not associated with performance measures or parental report of functioning. The participants demonstrate mild-to-moderate attention and EF impairment compared to the normative population. Clinicians, families, and educators should be informed about the neurocognitive sequelae of PAIS and the need for close developmental surveillance in this population to identify vulnerable children and initiate appropriate therapeutic interventions in a timely fashion.     

Youth with Oppositional Defiant Disorder at Entry into Home-Based Treatment,Foster Care,and Residential Treatment

We explored and compared rates of youth diagnosed with oppositional defiant disorder (ODD) at entry into three broad program types, home-based care, foster care, and residential care. We also explored factors other than an ODD diagnosis that could be associated with program placement, and compared the presence of these factors in youth with and without an ODD diagnosis. Analyses were conducted using data from an ongoing, private-agency led, outcome measurement project. Programs were grouped into low (home-based), moderate (foster), or high (residential) categories, based upon levels of supervision and structure provided. A sample of 9,564 youth admitted into care between years 2005 and 2007 was used. Results suggested the following rates of ODD: 14.2 % overall; 7.9 % for low level programs; 5.3 % for moderate level programs; 21.1 % for high level programs. Rates were significantly different by program level (p ≤ 0.001). Sixty of 65 additional risk factors were also significantly associated with placement by level of program. No risk factors were unique to youth with ODD. Of the significant factors for youth with ODD, 4 were particularly strong: Classification as a child in need of services (CHINS), history of neglect, verbal aggression, and truancy. Youth classified as CHINS and with substantiated or suspected neglect were more likely placed into a moderate level program. Youth with verbal aggression or truancy were more likely placed into a high level program. Results suggested many factors are considered at program entry. Given the potential for poor prognosis and social costs of ODD, results support an individualized approach to placement determinations, with increased attention to symptoms of ODD and associated features at program entry.     

Timed performance weaknesses on computerized tasks in pediatric brain tumor survivors: A comparison with sibling controls

With more children surviving a brain tumor, insight into the late effects of the disease and treatment is of high importance. This study focused on profiling the neurocognitive functions that might be affected after treatment for a pediatric brain tumor, using a broad battery of computerized tests. Predictors that may influence neurocognitive functioning were also investigated. A total of 82 pediatric brain tumor survivors (PBTSs) aged 8–18 years (M = 13.85, SD = 3.15, 49% males) with parent-reported neurocognitive complaints were compared to a control group of 43 siblings (age M = 14.27, SD = 2.44, 40% males) using linear mixed models. Neurocognitive performance was assessed using measures of attention, processing speed, memory, executive functioning, visuomotor integration (VMI), and intelligence. Tumor type, treatment, tumor location, hydrocephalus, gender, age at diagnosis, and time since diagnosis were entered into regression analyzes as predictors for neurocognitive functioning. The PBTSs showed slower processing speeds and lower intelligence (range effect sizes .71–.82, p < .001), as well as deficits in executive attention, short-term memory, executive functioning, and VMI (range effect sizes .40–.57, p < .05). Older age at assessment was associated with better neurocognitive functioning (B = .450, p < .001) and younger age at diagnosis was associated with lower intelligence (B = .328, p < .05). Medical risk factors, e.g., hydrocephalus, did not show an association with neurocognitive functioning. Late effects in PBTSs include a broad range of neurocognitive deficits. The results suggest that even PBTSs that were traditionally viewed as low risk for neurocognitive problems (e.g., surgery only, no hydrocephalus) may suffer from decreased neurocognitive functioning.     

Relationship of cognitive strategy use to prospective memory performance in a diverse sample of nondemented older adults with varying degrees of cognitive complaints and impairment

Although older adults typically have better performance on prospective memory (PM) tasks carried out in naturalistic settings, a paucity of research directly assesses older adults’ use of compensatory strategies on such tasks. The current study investigates external memory strategy use during performance of a clinical PM test that features both short-term (in laboratory) and long-term (out of laboratory) subtasks (i.e., the Royal Prince Alfred Prospective Memory Test – RPA-ProMem. Nondemented, community-dwelling older adults (n = 214; mean age = 80.5; 68.2% female; 39.7% non-white) with mild cognitive impairment, subjective cognitive decline, and healthy controls completed the RPA-ProMem while external strategy use was permitted and recorded. Overall, participants utilized external strategies 41% of the time on the RPA-ProMem. Increased utilization of external memory strategies was significantly associated with better PM performance. Additionally, better performance on executive functioning tasks was associated with increased use of external memory strategies. Results are discussed in relation to how memory strategy use can be enhanced to improve everyday memory ability in older adults at risk for dementia.     

Brief report: Relationship between performance testing and parent report of attention and executive functioning profiles in children following perinatal arterial ischemic stroke

Children with perinatal arterial ischemic stroke (PAIS) have increased rates of attention and executive functioning (EF) weaknesses. Research in other pediatric disorders has documented poor consistency between parent report of these skills and performance-based measures. We compared these data sources in children with PAIS. Forty full-term (≥37 weeks) children ages 3–16 (median = 7.2 years; 58% male) with PAIS completed neuropsychological testing and composite scores were created for seven attention and EF domains (Processing Speed; Attention; Working Memory; Verbal Retrieval; Inhibitory Control; Flexibility/Shifting; Planning). Parents completed “real-world” functioning questionnaires (ADHD Rating Scale-IV, BRIEF). Correlational analysis were used to compare parent and performance measures. Correlations between ADHD Rating Scale-IV scores and the performance-based Attention and Inhibition composite scores were nonsignificant. Significant negative correlations were found between the BRIEF GEC and performance-based Verbal Retrieval and Processing Speed composites, but remaining GEC/composite comparisons were nonsignificant. Analyses between parent report BRIEF index scores and the corresponding performance-based domain identified one significant negative correlation between the BRIEF Working Memory Index and the Working Memory composite score. While children with PAIS demonstrate difficulties in attention and EF on both parent report and performance measures, little significance was found in comparisons of these two types of measures. There may be several explanations for this dissociation: measures assessing different aspects of the same underlying construct; performance-based measures lacking ecological validity; and parents underestimating/underreporting their child’s deficits. Thus, multiple sources of informant and performance data are necessary to make more accurate conclusions about functioning in these domains.     

Memory deficits for non-amnestic mild cognitive impairment

Non-amnestic mild cognitive impairment (naMCI) is one of the clinical subtypes of mild cognitive impairment (MCI). However, the characteristics of memory deficits in naMCI as assessed by clinical neuropsychological evaluations are not clear. In this study, a battery of neuropsychological tests was administered to 122 cognitively normal controls (NC), 133 amnestic mild cognitive impairment (aMCI) patients, and 72 naMCI patients. The results showed that in individuals with naMCI, episodic memory, and other cognitive domains were impaired. The Prospective Memory Test (PMT) event-based prospective memory (EBPM), the Symbol Digit Modalities Test (SDMT) Accidental Memory, Stick test (ST) visuoconstructional memory, and ST Working Memory were impaired, yet did not reach the level of aMCI. Semantic memory was affected to a degree comparable with aMCI. Some functions like Auditory Verbal Learning Test (AVLT) recognition, and Judgment of Confidence (JOC) were maintained, as well as PMT Time-Based Prospective Memory (TBPM). This study verified that memory impairment among individuals with naMCI was mainly in memory functions mediated by the frontotemporal cortex.     

Does prospective memory influence quality of life in community-dwelling older adults?

Older adults commonly experience declines in prospective memory, which describes one’s ability to “remember to remember,” and can adversely affect instrumental activities of daily living and healthcare compliance. However, the extent to which prospective memory failures may influence quality of life in typically aging older adults is not well understood. One-hundred and four community-dwelling older Australians (aged 50 to 82 years) were administered a comprehensive, neuropsychological battery that included the Memory for Intentions Screening Test (MIST), Prospective and Retrospective Memory Questionnaire (PRMQ), Instrumental Activities of Daily Living Questionnaire (IADLQ), and World Health Organization Quality of Life-8 (WHOQOL-8). Multiple regressions controlling for negative affect, medical comorbidities, and other neurocognitive functions revealed an interaction between prospective memory and instrumental activities of daily living in the concurrent prediction of quality of life. Among the 39 older adults who reported multiple problems on the IADLQ, lower performance-based prospective memory (MIST) and higher self-reported prospective memory failures in daily life (PRMQ) were significantly associated with lower quality of life (WHOQOL-8). Conversely, no significant associations were observed between prospective memory and quality of life in the 65 participants without IADL problems. Prospective memory difficulties adversely impact quality of life in community-dwelling older adults who experience problems independently managing their instrumental activities of daily living. These findings extend prior literature showing that prospective memory plays a unique role in the real-world outcomes of older adults and clinical populations and highlight the need to develop effective strategies to enhance prospective memory functioning in these vulnerable groups.     

COMT and DAT1 polymorphisms moderate the indirect effect of parenting behavior on youth ADHD symptoms through neurocognitive functioning

Although gene × environment interactions contribute to youth attention-deficit/hyperactivity disorder (ADHD) symptoms, the pathways mediating these influences are unknown. We tested genetic moderation of indirect effects from parenting behavior to youth ADHD symptoms through multiple neurocognitive factors. Two hundred and twenty-nine youth with and without ADHD were assessed at baseline (Wave 1; ages 5–10) and at a 2-year follow-up (Wave 2; ages 7–13). At Wave 1, youth completed a neurocognitive battery including measures of response inhibition, visuospatial working memory, and fluid reasoning, and a standardized parent–child interaction task yielding observational measures of positive and negative parenting. At Wave 2, youth psychopathology was rated by parents and teachers using multiple methods (i.e., structured interview, rating scale). We employed moderated multiple mediation and compared conditional indirect effects across youth genotypes at two biologically plausible genetic loci. Controlling for parent ADHD symptoms as well as youth demographic factors and co-occurring externalizing symptoms, these genetic factors moderated the indirect effect from Wave 1 parenting to multi-method/informant Wave 2 ADHD symptoms through Wave 1 neurocognitive functioning. This preliminary study is the first to identify genetic moderation of mediated effects underlying ADHD symptoms and suggests that specific gene × parenting interactions may underlie neurocognitive functioning deficits and subsequent ADHD.     

Functional neuroimaging of working memory in survivors of childhood brain tumors and healthy children: Associations with coping and psychosocial outcomes

Purpose: Pediatric brain tumors are the second most common cancer diagnosis in individuals under age 20 and research has documented significant neurocognitive, psychosocial, and emotional late effects. Associations among these deficits have not been adequately considered and the role of survivors’ coping with stress in relation to deficits is unknown. Further, research has yet to examine neurobiological processes related to neurocognitive, psychosocial, and emotional difficulties in survivors through the use of functional neuroimaging. Method: Questionnaire measures and functional neuroimaging were used to examine the neurocognitive, psychosocial, and emotional functioning and coping responses of survivors of pediatric brain tumors (N = 17; age 8–16) and healthy children (N = 15). Results: Survivors experienced elevated levels of psychosocial and behavioral/emotional difficulties relative to healthy controls and normative data. Increases in brain activation in prefrontal and other anterior regions in response to a working memory task were associated with better psychosocial functioning, use of engagement coping strategies, and less use of disengagement coping strategies. Regression analyses suggest coping accounts for a significant portion of the association between brain activation and behavioral/emotional functioning. Conclusions: This study extends late-effects research by examining neurobiological processes associated with psychosocial and emotional difficulties. These findings contribute to our understanding of difficulties in survivors and provide a foundation for research exploring these associations and mediators of deficits in future longitudinal studies.     

Evaluation of prospective memory training for individuals with mild Alzheimer's disease

Prospective memory (PM) refers to the timely execution of a previously formed intention. PM deficits are one of the earliest measurable deficits in Alzheimer's disease (AD; Huppert & Beardsall, 1993) and yet, there has been little systematic research devoted to identifying ways in which these deficits can be compensated for or minimized. In this pilot study, individuals with mild AD participated in a new training program aimed at improving PM performance on an experimental PM task. PM training consisted of errorless learning and spaced retrieval techniques taught in six sessions in subjects' homes. Results showed that compared to untrained AD controls. AD patients who received PM training performed a PM task successfully across 7 weeks posttreatment (over 90% accuracy; controls 16-33% accuracy).     

Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT

This pilot randomized controlled trial (RCT) investigated benefits of omega-3 fatty acid supplementation and Individual-Family Psychoeducational Psychotherapy (PEP; a family-focused, cognitive-behavioral therapy) for behavior problems among youth with depression. Participants aged 7–14 with DSM-IV-TR depressive disorders (N = 72; 56.9 % male) were randomized to 1 of 4 treatment conditions: PEP + omega-3, PEP monotherapy (with pill placebo), omega-3 monotherapy, or placebo (without active intervention). At screen, baseline, and 2, 4, 6, 9, and 12 weeks post-baseline, parents completed the SNAP-IV, which assesses attention-deficit/hyperactivity disorder symptoms, oppositional defiant disorder symptoms, and overall behavior problems. At screen, baseline (randomization), 6 and 12 weeks, parents completed the Eyberg Child Behavior Inventory (ECBI), which includes Intensity and Problem scales for child behavior problems. Youth who had a completed SNAP-IV or ECBI for at least two assessments during treatment (n = 48 and 38, respectively) were included in analyses of the respective outcome. ClinicalTrials.gov.:NCT01341925. Linear mixed effects models indicated a significant effect of combined PEP + omega-3 on SNAP-IV Total (p = 0.022, d = 0.80) and Hyperactivity/Impulsivity trajectories (p = 0.008, d = 0.80), such that youth in the combined group saw greater behavioral improvement than those receiving only placebo. Similarly, youth in combined treatment had more favorable ECBI Intensity trajectories than youth who received no active treatment (p = 0.012, d = 1.07). Results from this pilot RCT suggest that combined PEP + omega-3 is a promising treatment for co-occurring behavior symptoms in youth with depression.     

Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and chronic mental health condition that often results in substantial impairments throughout life. Although evidence-based pharmacological and psychosocial treatments exist for ADHD, effects of these treatments are acute, do not typically generalize into non-treated settings, rarely sustain over time, and insufficiently affect key areas of functional impairment (i.e., family, social, and academic functioning) and executive functioning. The limitations of current evidence-based treatments may be due to the inability of these treatments to address underlying neurocognitive deficits that are related to the symptoms of ADHD and associated areas of functional impairment. Although efforts have been made to directly target the underlying neurocognitive deficits of ADHD, extant neurocognitive interventions have shown limited efficacy, possibly due to misspecification of training targets and inadequate potency. We argue herein that despite these limitations, next-generation neurocognitive training programs that more precisely and potently target neurocognitive deficits may lead to optimal outcomes when used in combination with specific skill-based psychosocial treatments for ADHD. We discuss the rationale for such a combined treatment approach, prominent examples of this combined treatment approach for other mental health disorders, and potential combined treatment approaches for pediatric ADHD. Finally, we conclude with directions for future research necessary to develop a combined neurocognitive + skill-based treatment for youth with ADHD.     

Emotional reactivity to daily events in youth with anxiety disorders

Background: Although research supports associations between anxiety and emotional reactivity in adults (Cisler, J. M., Olatunji, B. O., Feldner, M. T., &; Forsyth, J. P. (2010). Emotion regulation and the anxiety disorders: an integrative review. Journal of Psychopathology and Behavioral Assessment, 32(1), 68–82.), few studies have examined emotional reactivity in anxious youth (e.g., Carthy et al., 2010; Tan, P. Z., Forbes, E. E., Dahl, R. E., Ryan, N. D., Siegle, G. J., Ladouceur, C. D., &; Silk, J. S. (2012). Emotional reactivity and regulation in anxious and nonanxious youth: a cell-phone ecological momentary assessment study. Journal of Child Psychology and Psychiatry, 53(2), 197–206.). Methods: Using daily diary methodology, this study examined both negative affect (NA) and positive affect (PA) reactivity to daily events in youth diagnosed with anxiety (N?=?68; 60% female; 78% non-Hispanic White; M age?=?11.18 years, SD?=?3.17). We also examined whether parent-reported emotion regulation would predict emotional reactivity. Results: Participants reported more NA on days they experienced more negative parent and teacher events and less PA on days that they experienced more negative peer events. Additionally, better emotion regulation was associated with less NA reactivity to negative teacher events and to both negative and positive academic events. Conclusions: Interpersonal events have a salient effect on daily affect for anxious youth. Youth anxiety therapists should target emotion regulation associated with negative events involving adults and address barriers to developing and maintaining positive peer relationships.     

The relationship between emotional clarity and suicidal ideation among trauma-exposed adolescents in inpatient psychiatric care: does distress tolerance matter?

ABSTRACT

The present investigation examined associations between low emotional clarity (the extent to which individuals are confused about the specific emotions they are experiencing) and suicidal ideation in a diverse sample of trauma-exposed inpatient adolescents, as well as the moderating role of distress tolerance (DT) in this association. Participants (N = 50; 52.0% female; M = 15.1 years, SD = .51; 44% White) completed measures of emotion dysregulation, posttraumatic stress disorder (PTSD), and suicidal ideation/attempts, as well as a behavioral measure of DT. Controlling for age, gender, presence of mood disorder, and past history of attempts, results revealed a significant interaction between DT and low emotional clarity in relation to suicidal ideation. Specifically, lower emotional clarity was related to suicidal ideation at higher, but not lower, levels of DT. Findings suggest that presence of suicidal ideation among traumatized youth with low emotion clarity is most likely when these emotional deficits are coupled with a high tolerance for cognitive/psychological distress. Given that the ability to withstand distress is arguably a key factor in transitioning individuals from ideation to lethal suicidal behavior, attention to the presence of this construct in the context of clinical practice may be warranted.     

Neurocognitive Functioning in Depressed Young People: A Systematic Review and Meta-Analysis

Background: Depression is among the most common mental health problems for young people. In adults, depression is associated with neurocognitive deficits that reduce the effectiveness of treatment and impair educational and vocational functioning. Compared to adults, less is known about the neurocognitive functioning of young people with depression, and existing research has reported inconsistent findings. Method: This systematic review and meta-analysis synthesized the literature on neurocognitive functioning in currently depressed youth aged 12–25 years in comparison to healthy controls. Results: Following a systematic review of the literature, 23 studies were included in the meta-analysis. Poorer performance in the domains of attention (SMD: .50, 95% CI: .18–.83, p?=?.002), verbal memory (SMD: .78, 95% CI: .50–1.0, p?<?.001), visual memory (SMD: .65, 95% CI: .30–.99, p?<?.001), verbal reasoning/knowledge (SMD: .46; 95% CI: .14–.79; p?<?0.001) and IQ (SMD: .32; 95% CI: .08–.56; p?=?0.01) were identified in depressed youth. Relative weaknesses in processing speed/reaction time and verbal learning were also evident, however, these findings disappeared when the quality of studies was controlled for. Moderator analysis showed a tendency for poorer set-shifting ability in younger depressed participants relative to controls (although non-significant; p?=?.05). Moderator analysis of medication status showed taking medication was associated with poorer attentional functioning compared to those not taking medication. Conclusion: The findings suggest that currently depressed young people display a range of neurocognitive weaknesses which may impact treatment engagement and outcome. The findings support the need to consider neurocognitive functioning when treating youth with depression.