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Introduction: Intraindividual variability across a battery of neuropsychological tests (IIV-dispersion) can reflect normal variation in scores or arise from cognitive impairment. An alternate interpretation is IIV-dispersion reflects reduced engagement/invalid test data, although extant research addressing this interpretation is significantly limited., Method: We used a sample of 97 older adult (mean age: 69.92), predominantly White (57%) or Black/African American (34%), and predominantly cis-gender male (87%) veterans. Examinees completed a comprehensive neuropsychological battery, including measures of reduced engagement/invalid test data (a symptom validity test [SVT], multiple performance validity tests [PVTs]), as part of a clinical evaluation. IIV-dispersion was indexed using the coefficient of variance (CoV). We tested 1) the relationships of raw scores and "failures" on SVT/PVTs with IIV-dispersion, 2) the relationship between IIV-dispersion and validity/neurocognitive disorder status, and 3) whether IIV-dispersion discriminated the validity/neurocognitive disorder groups using receiver operating characteristic (ROC) curves., Results: IIV-dispersion was significantly and independently associated with a selection of PVTs, with small to very large effect sizes. Participants with invalid profiles and cognitively impaired participants with valid profiles exhibited medium to large (d = .55-1.09) elevations in IIV-dispersion compared to cognitively unimpaired participants with valid profiles. A non-significant but small to medium (d = .35-.60) elevation in IIV-dispersion was observed for participants with invalid profiles compared to those with a neurocognitive disorder. IIV-dispersion was largely accurate at differentiating participants without a neurocognitive disorder from invalid participants and those with a neurocognitive disorder (areas under the Curve [AUCs]=.69-.83), while accuracy was low for differentiating invalid participants from those with a neurocognitive disorder (AUCs=.58-.65)., Conclusions: These preliminary data suggest IIV-dispersion may be sensitive to both neurocognitive disorders and compromised engagement. Clinicians and researchers should exercise due diligence and consider test validity (e.g. PVTs, behavioral signs of engagement) as an alternate explanation prior to interpretation of intraindividual variability as an indicator of cognitive impairment.

Bipolar disorder (BD) 1 implies impairments in executive functions during euthymia that interfere in psychosocial functioning. Virtual reality assessments may confer advantages respect to traditional assessments in terms of efficiency and ecological validity. The aim of this study was to validate a novel Virtual Cooking Task (VCT) for executive functions assessment in euthymic patients with BD. This is a cross-sectional study in which a group of BD patients (n = 42) and healthy controls (n = 42) were assessed with the VCT and a battery of computerized standard tasks (CST). Additionally, the influence on psychosocial functioning of both forms of assessment, measured with the FAST, was investigated to check ecological validity. In BD group significant impairments in interference, working memory and sustained attention were found in CST and VCT respect to controls. However, deficits in planning and problem-solving were also revealed with the VCT. With respect to psychosocial functioning, only VCT variables were able to predict FAST scores at the assessment time. The VCT showed a greater sensitivity than CST to assess executive functions and real-life functioning in BD. This provides evidence about the opportunity to design novel cognitive assessments for diagnostic and therapeutic purposes in BD., Competing Interests: Declaration of competing interest The authors declare no conflict of interest regarding this publication., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Few studies have focused on functional impairment in depressed patients during symptomatic remission. The exact relationship between cognitive performance and functional outcomes of patients with Major depressive disorder (MDD) remains unclear., Methods: Participants diagnosed with MDD were included and interviewed at both baseline and follow-up. Cognitive function was assessed during acute episodes using the Cambridge Neuropsychological Test Automated Battery (CANTAB), which targeted attention (Rapid Visual Processing - RVP), visual memory (Pattern Recognition Memory - PRM), and executive function (Intra-Extra Dimensional Set Shift - IED). The 17-item Hamilton Depression Scale (HAMD) was used for symptom assessment. Participants were divided into two groups based on their SDSS (Social Disability Screening Schedule) scores, and the differences between their demographic information, HAMD scores, and baseline CANTAB test results were compared. Logistic regression analysis was used to identify cognitive predictors of social function during symptomatic remission., Results: According to the SDSS score at follow-up, 103 patients were divided into the normal social function group (n = 81,78.6%) and the poor social function group (n = 22, 21.4%) during clinical remission. Participants with poorer social function performed worse in the visual memory (PRM) and executive function tests (IED) at the baseline. Logistic regression analysis suggested that performance on the PRM (95%CI = 0.31-0.93, p = 0.030) and IED (95%CI = 1.01-1.13, p = 0.014) tests, instead of less severe symptoms, significantly contributed to functional outcomes., Conclusion: Better performance in visual memory and executive function during acute episodes may predict better social functional outcomes in individuals with MDD. A potential early intervention to improve social function in individuals with MDD could include the treatments for executive function and visual memory., (© 2024. The Author(s).)

To make assessment of neurocognitive decline in patients with brain metastases more reliable and feasible, Brainlab AG developed an application 'Cognition' for the iPad by gamifying validated paper and pencil tests. This study aims at validating the computerized tests. We assessed reliability and comparability of 'Cognition' with similar well-established paper and pencil tests in two consecutive sessions per participant. The electronic tests used the same assignments with different stimuli than the paper and pencil tests. Domains involved are learning and memory, attention and processing speed, verbal fluency and executive functions. In total 5 employees and 25 cancer patients without disease in the CNS participated, of whom 24 completed both sessions. Reliability was found satisfying for the domains learning and memory (p = 0.08; p = 0.612; p = 0.4445) and verbal fluency (p = 0.064). A learning effect showed for attention and processing speed (p = 0.001) while executive functioning showed a significant decline, possibly due to radiotherapy-related fatigue (p = 0.013). Concerning comparability between electronic and paper results, a significant correlation was found for attention and processing speed (p = 0.000), for verbal fluency (p = 0.03), for executive functions (p = 0.000), but not for learning and memory (p = 0.41; p = 0.25). Overall 'Cognition' showed moderate comparability, probably caused by the consecution of tests during sessions and the unfamiliarity with electronic test in older patients. After improving its functionality, the application needs to be validated in patients with brain metastases before it can detect cognitive decline and possible early radiation toxicity or relapses., (© 2021. Belgian Neurological Society.)

Neurocognitive deficits are associated with impaired global functioning and psychotic symptoms. However, whether symptoms can mediate the relationship between neurocognition and global functioning in adolescent psychosis is unclear. Here, we investigated if symptoms assessed with the Positive And Negative Syndrome Scale (PANSS), mediated the relationship between neurocognitive performance and global functioning in adolescents with non-affective early-onset psychotic disorders (EOP). Sixty-one adolescent EOP patients (age 12-18 years) from 2 Norwegian clinical cohorts were included. Linear regression models were applied to investigate associations between neurocognitive domains from the MATRICS Consensus Cognitive Battery (MCCB) and global functioning. PANSS symptoms were analyzed using the Wallwork/Fortgang five-factor model. Using the INDIRECT macro for SPSS, mediation effects were tested using bootstrapping with 95% bias corrected confidence intervals. Verbal learning was positively associated with global functioning (P < 0.001) and negatively associated with the disorganized symptom factor (P = 0.002), controlling for age, sex and cohort. Testing of indirect effects, controlling for age, sex and cohort, showed that the Negative (point estimate = 1.56, 95% CI 0.22, 3.47) and Disorganized (point estimate = 1.24, 95% CI 0.05, 3.69) symptom factors significantly mediated the relationship between verbal learning and global functioning. We found that verbal learning, negative and disorganized symptoms influenced global functioning in adolescents with EOP, while reality-distorted positive symptoms did not. These results suggest that assessing these domains in EOP is helpful for planning treatment and rehabilitation programs focusing on functional outcome.

The ecological validity of neuropsychological testing (NT) has been questioned in the sports environment. A frequent criticism is that NT, mostly consisting of pen and paper or digital assessments, lacks relevant bodily movement. This study aimed to identify the determinants of a newly developed testing battery integrating both cognitive and motor demands. Twenty active individuals (25 ± 3 years, 11 males) completed the new motor-cognitive testing battery (MC), traditional NT (Stroop test, Trail Making test, Digit Span test) and isolated assessments of motor function (MF; Y-balance test, 20m-sprint, counter-movement jump). Kendal's tau and partial Spearman correlations were used to detect associations between MC and NT/MF. Except for two items (Reactive Agility A and counter-movement jump; Run-Decide and sprint time; r = 0.37, p < 0.05), MC was not related to MF. Similarly, MC and NT were mostly unrelated, even when controlling for the two significant motor covariates ( p > 0.05). The only MC item with (weak to moderate) associations to NT was the Memory Span test (Digit Span backwards and composite; r = 0.43-0.54, p < 0.05). In sum, motor-cognitive function appears to be largely independent from its two assumed components NT and MF and may represent a new parameter in performance diagnostics.

Background: Autism Spectrum Disorder (ASD) and schizophrenia are neurodevelopmental disorders which share substantial overlap in cognitive deficits during adulthood. However, treatment evaluation in ASD and treatment comparisons across ASD and schizophrenia are limited by a dearth of empirical work establishing the validity of a standard cognitive battery across ASD and schizophrenia. Promisingly, the MATRICS Consensus Cognitive Battery (MCCB) has been validated in schizophrenia and encompasses cognitive domains that are impacted in ASD. Thus, this study aimed to establish MCCB's generalizability from schizophrenia to ASD., Methods: Community-residing adults with schizophrenia (N = 100) and ASD (N = 113) underwent MCCB assessment. Using multigroup confirmatory factor analysis, MCCB's transdiagnostic validity was evaluated by examining whether schizophrenia and ASD demonstrate the same configuration, magnitude, and directionality of relationships within and among measures and their underlying cognitive domains., Results: Across schizophrenia and ASD, the same subsets of MCCB measures inform three cognitive domains: processing speed, attention/working memory, and learning. Except for group means in category fluency, continuous performance, and spatial span, both groups show vastly comparable factor structures and characteristics., Conclusions: To our knowledge, this study is the first to establish the validity of a standard cognitive battery in adults with ASD and furthermore the first to establish a cognitive battery's comparability across ASD and schizophrenia. Cognitive domain scores can be compared across new samples using weighted sums of MCCB scores resulting from this study. These findings highlight MCCB's applicability to ASD and support its utility for standardizing treatment evaluation of cognitive outcomes across the autism-schizophrenia spectrum.

Introduction: Theory of mind (ToM) has been established as one of the most investigated and pronounced social cognitive deficits in schizophrenia. Yet, knowledge on whether measures of ToM can be used and compared across cultures is sparse. In this study, we used two simple, non-verbal ToM tests in patients with schizophrenia and non-clinical controls from China and Denmark to investigate whether culture has an impact on ToM performance. Methods: Sixty-six patients with schizophrenia (35 Chinese) and 67 matched non-clinical controls (38 Chinese) from China and Denmark were tested with Brünés Picture Sequencing Task and Animated Triangles Task. We compared three models for each outcome variable in order to investigate which model best fitted the data: the first model included group (controls, patients) as a predictor variable, the second included group and nationality (Chinese, Danish), and the third included both predictors and their interaction. Results: On most ToM subtests, culture seemed to play a role. Only performance on Brüne's 1st order ToM were best described as similar in both countries. The second model had the best fit for most of the subtests indicating that the difference between patients and controls in China and Denmark, respectively, is similar. Conclusions: Caution to cultural differences should be taken when comparing ToM in Asian and Western patients with schizophrenia as well as healthy individuals.

Background: Primary dystonia has been traditionally viewed as a motor disorder. However, non-motor symptoms are frequently present and significantly quality of life. Neuropsychiatric and cognitive symptoms have been identified, but prior studies have been limited in sample size and lack of control groups. This study examined the neurocognitive profile of a sample of persons with primary dystonia (PWD) as compared to demographically matched healthy control group., Methods: A cognitive test battery was administered to 25 PWD who presented for pre-surgical candidacy evaluation for deep brain stimulation surgery. The test battery domains included global cognitive function, attention, expressive language, visuospatial skills, memory, and executive functioning. Twenty-five age, gender, education-matched healthy control participants were compared to the PWD., Results: Compared to demographically matched healthy controls, PWD performed worse on measures of global cognitive function, attention, memory, and conceptualization. Based on normative comparison, a large portion of PWD were impaired on tasks of executive functioning and expressive language. Over 80% of the PWD showed impairment on at least one neurocognitive measure and over 60% showed impairment on 3 or more tests., Conclusions: Neurocognitive deficits were prevalent among our PWD sample. These impairments were present across a broad range of cognitive domains. Given the degree of cognitive impairment found in this study, our results have implications for health care providers with providing interventions to PWD., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This study investigated the neurocognitive predictors of length of stay (LOS) within a children's psychiatric inpatient program. A medical chart review was conducted for 96 children aged 6-14 years who received a neuropsychological evaluation during hospitalization. Correlation and linear regression analyses examined the influence of neurocognition (memory, construction, executive functioning [EF], and intelligence [IQ]) on subsequent LOS. Impairment/performance was calculated by the standard mean composite score and global deficit score (GDS) approaches for each domain and for overall neurocognition. Rates of impairment were similar between the two approaches (ranging from 22.9% to 45.8% across domains). Overall neurocognition (r = .347 & -.270, respectively), EF (r = .333 & -.261, respectively), and construction (r = .287 & -.240), respectively, were significantly associated with LOS utilizing the GDS and composite approaches. After controlling for clinical/demographic predictors of LOS, GDS-Total, GDS-EF/Construction, and EF/Construction composite scores significantly predicted LOS. Further, receiver operating characteristic (ROC) curve detected the GDS was able to distinguish between those children that would and would not end up having a prolonged hospitalization. The GDS and composite score approaches to neurocognitive impairment detection were similarly able to capture neurocognitive impairment and the association of impairment to LOS within a children's psychiatric inpatient program.

Aim: Neurocognitive deficits are pervasive and enduring features of severe mental illness that appear before the onset of clinical symptoms and contribute to functional disability. However, it remains unclear how individuals who display warning signs for psychotic or mood disorders compare on their neurocognitive profiles since previous studies have separately examined neurocognition in both groups. Therefore, the purpose of this study was to directly compare performance on a range of neurocognitive tasks in individuals with emerging psychotic or mood symptoms., Methods: Participants were drawn from a database of individuals who completed a comprehensive assessment at a university-based assessment centre. We examined 3 groups: individuals who endorsed elevated psychotic symptoms (EPS; n = 64), individuals who endorsed elevated depressive symptoms (EDS; n = 58), or non-clinical comparisons (NCC; n = 57) without any elevated psychiatric symptoms or diagnoses., Results: EPS participants performed worse than NCC and EDS groups on verbal comprehension, working memory and cognitive flexibility, and worse than NCC, but not EDS, on perceptual reasoning. There were no significant differences between groups on processing speed, verbal fluency and set-shifting. EDS performed worse than both EPS and NCC groups on psychomotor speed. Dimensionally, poorer cognitive functioning was more strongly related to EPS than depressive symptoms., Conclusions: These findings highlight the distinct yet overlapping neurocognitive profiles of both groups with emerging psychiatric symptoms, and suggest that, despite having no formal diagnosis, individuals with EPS exhibit observable cognitive impairment and may still benefit from interventions within academic and workplace contexts., (© 2018 John Wiley & Sons Australia, Ltd.)

Objective: The aim of this study was to develop standardized scores and scoring tables for test performance in healthy adolescents for the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) for each year from 11 to 19 years of age, by sex, with T scores and percentile ranks., Methods: A total of 502 healthy participants (aged 11-19 years) from 7 cohorts from Ireland, Norway, Sweden, and United States, were included in this multisite study. Regression-predicted means for the MCCB tests, except the social cognition subtest, were calculated using the MCCB test scores as outcome variables and age, age2, sex, age × sex as predictors. The regression-predicted means for each combination of age and sex were added with the residuals from the entire cohort to yield the expected distribution of that group. Age effects were examined using regression models with age and age2 as predictors. Sex differences were examined using Student's t-tests., Results: Significant positive age effects were found for all tests, except for the Brief Visuospatial Memory Test, revised (BVMT-R; measure of visual learning). Females performed significantly better than males on BACS Symbol coding (measure of speed of processing) and BVMT-R, while males performed significantly better than females on NAB Mazes (measure of reasoning and problem solving). Based on the regression-predicted distributions of scores, 19 standardized scoring tables for each test and domain were created., Conclusions: With the results from this study, we have developed an accessible standardized data set of healthy adolescent test performance for the MCCB., (© The Author(s) 2018. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.)

Objective: When testing African children with developmental and cognitive standardized tests from high-income countries (HIC), investigators are uncertain as to whether to apply the HIC norms for these tests when standardizing a child's raw-score performance on the basis of age. The present study compared the construct validity of both raw and HIC-based standardized scores for the Mullen Scales of Early Learning (MSEL) and the Kaufman Assessment Battery in Children - 2nd edition (KABC-II) for Beninese children in a rural setting from three to six years of age., Methods: Seventy-four children 3-4 yrs of age were assessed with the MSEL, and 61 eligible older children (5-6 yrs of age) were assessed with the KABC-II. Assessors spoke the instructions to the children and caregivers for the assessment items in the local language. The developmental quality of the home environment was evaluated with the Caldwell Home Observation for Measurement of the Environment (HOME) inventory, and a material possessions and housing quality checklist was used as a measure of socio-economic status (SES). Children's mothers were given the Raven's Progressive Matrices test (nonverbal cognitive ability), and the Edinburgh Postpartum Depression Scale (EPDS) (emotional wellbeing)., Results: For the MSEL, the 4-yr old group performed significantly better than the 3-yr old group on both the raw and standardized score comparisons for all scales. These differences were attenuated when using standardized scores, although the MSEL standardized cognitive composite score was still highly significant between years of age. When comparing 5- to 6-yr olds on KABC-II subtest and global scale performance, comparisons between the raw and standardized mean score performances were much less consistent. Generally, 6-yr olds performed significantly better than 5-yr olds on the raw score comparisons on the KABC-II subtests, but not so for standardized scores. Parent-child interactions assessed through the HOME measure was associated with both raw and standardized MSEL cognitive composite score outcomes on a multiple regression analysis. SES was the only significant predictor for KABC-II raw and standardized outcomes., Conclusion: Standardization using HIC norms was not optimal, resulting in minimal impact to account for age when using the MSEL, and lower scores for oldest children compared with youngest children when using the KABC2. This is likely due to children in Benin drifting away from HIC-based norms with each passing year of age, systematically lowering standardized performance measures. These findings support the importance of having a local comparison group of reference or control children to allow for adjusted (for age, HOME, and SES) raw score comparisons when using western-based tests for developmental and neuropsychological evaluation., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Patients with an at-risk mental state (ARMS) for psychosis and patients with attention-deficit/hyperactivity disorder (ADHD) have many overlapping signs and symptoms and hence can be difficult to differentiate clinically. The aim of this study was to investigate whether the differential diagnosis between ARMS and adult ADHD could be improved by neuropsychological testing., Methods: 168 ARMS patients, 123 adult ADHD patients and 109 healthy controls (HC) were recruited via specialized clinics of the University of Basel Psychiatric Hospital. Sustained attention and impulsivity were tested with the Continuous Performance Test, verbal learning and memory with the California Verbal Learning Test, and problem solving abilities with the Tower of Hanoi Task. Group differences in neuropsychological performance were analyzed using generalized linear models. Furthermore, to investigate whether adult ADHD and ARMS can be correctly classified based on the pattern of cognitive deficits, machine learning (i.e. random forests) was applied., Results: Compared to HC, both patient groups showed deficits in attention and impulsivity and verbal learning and memory. However, in adult ADHD patients the deficits were comparatively larger. Accordingly, a machine learning model predicted group membership based on the individual neurocognitive performance profile with good accuracy (AUC = 0.82)., Conclusions: Our results are in line with current meta-analyses reporting that impairments in the domains of attention and verbal learning are of medium effect size in adult ADHD and of small effect size in ARMS patients and suggest that measures of these domains can be exploited to improve the differential diagnosis between adult ADHD and ARMS patients., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Objective: Clinical neuropsychologists have long underutilized computer technologies for neuropsychological assessment. Given the rapid advances in technology (e.g. virtual reality; tablets; iPhones) and the increased accessibility in the past decade, there is an on-going need to identify optimal specifications for advanced technologies while minimizing potential sources of error. Herein, we discuss concerns raised by a joint American Academy of Clinical Neuropsychology/National Academy of Neuropsychology position paper. Moreover, we proffer parameters for the development and use of advanced technologies in neuropsychological assessments., Method: We aim to first describe software and hardware configurations that can impact a computerized neuropsychological assessment. This is followed by a description of best practices for developers and practicing neuropsychologists to minimize error in neuropsychological assessments using advanced technologies. We also discuss the relevance of weighing potential computer error in light of possible errors associated with traditional testing. Throughout there is an emphasis on the need for developers to provide bench test results for their software's performance on various devices and minimum specifications (documented in manuals) for the hardware (e.g. computer, monitor, input devices) in the neuropsychologist's practice., Conclusion: Advances in computerized assessment platforms offer both opportunities and challenges. The challenges can appear daunting but are a manageable and require informed consumers who can appreciate the issues and ask pertinent questions in evaluating their options.

Decreased information processing speed (IPS) is frequently reported in pediatric multiple sclerosis (MS) patients. The computerized version of the Symbol Digit Modalities Test (c-SDMT) measures IPS over eight consecutive trials per session and additionally captures changes in performance within the session. Here, we establish normative c-SDMT performance and test-retest reliability in healthy children (HC) and explore differences in the overall c-SDMT-performance between HC and MS patients. This cross-sectional study included 478 HC (237 female, 49.5%) divided into five age groups (2 years each), and 27 MS patients (22 female, 81.5%) aged 8-18 years. The average time to complete the c-SDMT increased with age (|r| 0.70, 95% CI -0.74, -0.64). Test-retest reliability was high (ICC = 0.91) in HC. The total time to complete the c-SDMT did not differ between children with MS and sex- and age- matched HC (p = 0.23). However, MS patients were less likely to show faster performance across all the successive eight trials compared to HC (p = 0.0001). Healthy children demonstrate faster IPS with increasing age, as well as during successive trials of the c-SDMT. The inability of pediatric MS patients to maintain the increase in processing speed over successive trials suggests a reduced capacity for procedural learning, possibly resulting from cognitive fatigue.

Aim: Most studies on the determinants of psychosocial functioning in first-episode psychosis used few predictors. This study examines the effects of multiple cognitive domains and multiple symptoms on psychosocial functioning., Methods: A total of 162 patients with a first-episode psychosis were assessed within 3 months after referral to an early psychosis treatment department. Four psychopathological subdomains (positive and negative symptoms, depression and anxiety) and five subdomains of psychosocial functioning (work/study, relationships, self-care, disturbing behaviour and general psychosocial functioning) were measured. Neurocognitive and social cognitive factors were identified through principal component analyses (PCA) of a 15-measure cognitive battery. Stepwise backward regression models were computed to identify the determinants of psychosocial functioning., Results: The three neurocognitive and four social cognitive factors identified through PCA were largely independent of psychopathology. The strongest associations were between cognitive factors and anxiety. Higher levels of negative symptoms, poor general neurocognition and poor general social cognition showed strongest associations with impaired psychosocial functioning, followed by low verbal processing speed and low emotion processing speed. Together, these factors accounted for 39.4% of the variance in psychosocial functioning., Conclusions: The results suggest that negative symptoms, impaired neurocognition and poor social cognition are related to psychosocial problems in patients with first-episode psychosis. None of the affective or positive symptoms had a marked impact on psychosocial functioning., (© 2015 Wiley Publishing Asia Pty Ltd.)

Many randomized controlled trials (RCTs) of neuropsychiatric conditions involve cognitive outcome measures; however, validity of cognitive data relies on adequate effort during testing, and such screening is seldom performed. Given well-established rates of 10 to 30% poor effort in clinical settings, this is not a trivial concern. This preliminary study evaluated effort during cognitive testing in an RCT of omega-3 supplementation to reduce suicidality in a high-risk psychiatric population. An interim analysis of sustained attentions measures from the Connors Performance Test (CPT-2) at baseline for the first 60 participants was conducted. Previously validated cut points to detect insufficient effort on the CPT-2 were applied. At baseline, 12% (7) were identified as giving poor effort. Follow-up analyses indicated less psychiatric distress and suicidality among those who gave poor effort. Results suggest comparable likelihood of a poor effort on cognitive testing in clinical and RCT participation. Reduced psychiatric distress in the poor effort group raises concern regarding interpretation of other measures. The importance of screening cognitive data for effort in RCTs is highlighted. Future studies will examine effort at follow-up visits, and explore relationships to attrition, adherence, and response to treatment. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Increasingly, the effects of copy number variation (CNV) in the genome on brain function and behaviors are recognized as means to elucidate pathophysiology of psychiatric disorders. Such studies require large samples and we characterized the neurocognitive profile of two cohorts of individuals with 22q11.2 deletion syndrome (22q11DS), the most common CNV associated with schizophrenia, in an effort to harmonize phenotyping in multi-site global collaborations. The Penn Computerized Neurocognitive Battery (PCNB) was administered to individuals with 22q11DS in Philadelphia (PHL; n=155, aged 12-40) and Tel Aviv (TLV; n=59, aged 12-36). We examined effect sizes of performance differences between the cohorts and confirmed the factor structure of PCNB performance efficiency in the combined sample based on data from a large comparison community sample. The cohorts performed comparably with notable deficits in executive function, episodic memory and social cognition domains that were previously associated with abnormal neuroimaging findings in 22q11DS. In mixed model analysis, while there was a main effect for site for accuracy (number of correct response) and speed (time to correct response) independently, there were no main site effects for standardized efficiency (average of accuracy and speed). The fit of a structural model was excellent indicating that PCNB tests were related to the targeted cognitive domains. Thus, our results provide preliminary support for the use of the PCNB as an efficient tool for neurocognitive assessment in international 22q11DS collaborations., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Previous studies have reported that patients with bipolar disorder (BD) present with cognitive impairments during mood episodes as well as euthymic phase. However, it is still unknown whether reported neurocognitive abnormalities can objectively identify individual BD patients from healthy controls (HC)., Methods: A total of 21 euthymic BD patients and 21 demographically matched HC were included in the current study. Participants performed the computerized Cambridge Neurocognitive Test Automated Battery (CANTAB) to assess cognitive performance. The least absolute shrinkage selection operator (LASSO) machine learning algorithm was implemented to identify neurocognitive signatures to distinguish individual BD patients from HC., Results: The LASSO machine learning algorithm identified individual BD patients from HC with an accuracy of 71%, area under receiver operating characteristic curve of 0.7143 and significant at p=0.0053. The LASSO algorithm assigned individual subjects with a probability score (0-healthy, 1-patient). Patients with rapid cycling (RC) were assigned increased probability scores as compared to patients without RC. A multivariate pattern of neurocognitive abnormalities comprising of affective Go/No-go and the Cambridge gambling task was relevant in distinguishing individual patients from HC., Limitations: Our study sample was small as we only considered euthymic BD patients and demographically matched HC., Conclusion: Neurocognitive abnormalities can distinguish individual euthymic BD patients from HC with relatively high accuracy. In addition, patients with RC had more cognitive impairments compared to patients without RC. The predictive neurocognitive signature identified in the current study can potentially be used to provide individualized clinical inferences on BD patients., (Copyright © 2015 Elsevier B.V. All rights reserved.)

The MCCB is widely used in clinical trials of schizophrenia, but its relationship to occupational functioning still needs further elaboration. While previous research has indicated that various domains of neurocognition assessed by individual tests are related to work functioning, these reports preceded the development of the MCCB as the standard neurocognitive test battery in the field. In the current study, the vocational functioning of 131 Norwegian participants with schizophrenia spectrum disorders who were enrolled in a vocational rehabilitation program were assessed on the Vocational Cognitive Rating Scale (VCRS), the Work Behavior Inventory (WBI), and the Complexity Scale (CS) as well as on the MCCB. Significant correlations were found between most MCCB domains and VCRS Total Score. MCCB processing speed and attention were most powerfully related to and predictive of WBI scores. When participants were divided into "low complexity" or "higher complexity" work categories, participants in the "low-complexity" group performed significantly worse than participants in the "higher-complexity" group regarding processing speed, working memory, visual learning and the composite score. The same pattern emerged for participants working sheltered compared to competitive jobs. The VCRS, WBI and CS may be useful in vocational rehabilitation. They bridge an important gap between test- and occupational-setting, providing valuable information about impairments related to occupational functioning. We found the MCCB to be sensitive to occupational functioning as measured by VCRS, WBI and CS, with neurocognition accounting for a small but significant proportion of the variance in these different measures of occupational functioning., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: A Metacognitive Training for Schizophrenia patients (MCT) was developed to target the cognitive biases that characterize the illness. Results suggest positive MCT effects encompassing several aspects of psychopathology and subjective well-being. There are still open questions concerning the effect on different cognitive biases and the interplay between them and both psychopathology and neurocognition. Specifically, the bias against disconfirmatory evidence (BADE) has never been tested in previous trials on MCT. In this study we evaluated the feasibility of MCT combined with a cognitive remediation therapy (CACR) in schizophrenia and its effect on BADE. Moreover, we investigated the relationships between BADE and both neuropsychology and psychopathology, taking into account mutual influences on the degree of improvement., Methods: Fifty-seven schizophrenia outpatients were randomly assigned to CACR + control group or MCT+CACR and assessed at baseline and after treatment for psychopathology, neurocognition and BADE., Results: After MCT+CACR patients showed significantly greater improvements on BADE. Although BADE baseline performances correlated with several cognitive domains, no association was found between BADE improvement and neurocognitive nor psychopathological measures., Conclusions: This study enlightened for the first time the efficacy of MCT+CACR on BADE in schizophrenia, suggesting the importance to develop a more specific intervention tailored on individual needs of patients., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Background: The number of separable cognitive dimensions in schizophrenia has been debated. Guided by the extant factor analytic literature, the NIMH Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative selected seven cognitive domains relevant to treatment studies in schizophrenia: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. These domains are assessed in the MATRICS Consensus Cognitive Battery (MCCB). The aim of this study was to conduct a confirmatory factor analysis (CFA) of the beta battery of the MCCB to compare the fit of the MATRICS consensus seven-domain model to other models in the current literature on cognition in schizophrenia., Method: Using data from 281 schizophrenia outpatients, we compared the seven correlated factors model with alternative models. Specifically, we compared the 7-factor model to (a) a single-factor model, (b) a three correlated factors model including speed of processing, working memory, and general cognition, and (c) a hierarchical model in which seven first-order factors loaded onto a second-order general cognitive factor., Results: Multiple fit indices indicated the seven correlated factors model was the best fit for the data and provided significant improvement in model fit beyond the comparison models., Conclusions: These results support the assessment of these seven cognitive dimensions in clinical trials of interventions to improve cognition in schizophrenia. Because these cognitive factors are separable to some degree, it is plausible that specific interventions may have differential effects on the domains.

Neurocognitive impairment is a core feature in psychotic disorders and the MATRICS Consensus Cognitive Battery (MCCB) is now widely used to assess neurocognition in this group. The MATRICS has been translated into several languages, including Norwegian; although this version has yet to be investigated in an adult clinical population. Further, the relationship between the MATRICS and different measures of functioning needs examination. The purpose of this study was to describe neurocognition assessed with the Norwegian version of the MATRICS battery in a sample of patients with psychotic disorders compared to age and gender matched healthy controls and to examine the association with educational-, occupational- and social-functioning in the patient group. One hundred and thirty one patients and 137 healthy controls completed the battery. The Norwegian version of the MATRICS was sensitive to the magnitude of neurocognitive impairments in patients with psychotic disorders, with patients displaying significant impairments on all domains relative to healthy controls. Neurocognition was also related to both self-rated and objective functional measures such as social functioning, educational- and employment-history., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

The current study examined whether self-rated education quality predicts Wide Range Achievement Test-4th Edition (WRAT-4) Word Reading subtest and neurocognitive performance, and aimed to establish this subtest's construct validity as an educational quality measure. In a community-based adult sample (N = 106), we tested whether education quality both increased the prediction of Word Reading scores beyond demographic variables and predicted global neurocognitive functioning after adjusting for WRAT-4. As expected, race/ethnicity and education predicted WRAT-4 reading performance. Hierarchical regression revealed that when including education quality, the amount of WRAT-4's explained variance increased significantly, with race/ethnicity and both education quality and years as significant predictors. Finally, WRAT-4 scores, but not education quality, predicted neurocognitive performance. Results support WRAT-4 Word Reading as a valid proxy measure for education quality and a key predictor of neurocognitive performance. Future research should examine these findings in larger, more diverse samples to determine their robust nature., (© The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Impaired cognition is an important dimension in psychosis and its at-risk states. Research on the value of impaired cognition for psychosis prediction in at-risk samples, however, mainly relies on study-specific sample means of neurocognitive tests, which unlike widely available general test norms are difficult to translate into clinical practice. The aim of this study was to explore the combined predictive value of at-risk criteria and neurocognitive deficits according to test norms with a risk stratification approach., Method: Potential predictors of psychosis (neurocognitive deficits and at-risk criteria) over 24 months were investigated in 97 at-risk patients., Results: The final prediction model included (1) at-risk criteria (attenuated psychotic symptoms plus subjective cognitive disturbances) and (2) a processing speed deficit (digit symbol test). The model was stratified into 4 risk classes with hazard rates between 0.0 (both predictors absent) and 1.29 (both predictors present)., Conclusions: The combination of a processing speed deficit and at-risk criteria provides an optimized stratified risk assessment. Based on neurocognitive test norms, the validity of our proposed 3 risk classes could easily be examined in independent at-risk samples and, pending positive validation results, our approach could easily be applied in clinical practice in the future., (© The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Difficulties in everyday life activities are core features of persons diagnosed with schizophrenia and in particular during multitasking activities. However, at present, patients׳ multitasking capacities have not been adequately examined in the literature due to the absence of suitable assessment strategies. We thus recently developed a computerized real-life activity task designed to take into account the complex and multitasking nature of certain everyday life activities where participants are required to prepare a room for a meeting. Twenty-one individuals diagnosed with schizophrenia and 20 matched healthy controls completed the computerized task. Patients were also evaluated with a cognitive battery, measures of symptomatology and real world functioning. To examine the ecological validity, 14 other patients were recruited and were given the computerized version and a real version of the meeting preparation task. Results showed that performance on the computerized task was significantly correlated with executive functioning, pointing to the major implication of these cognitive processes in multitasking situations. Performance on the computerized task also significantly predicted up to 50% of real world functioning. Moreover, the computerized task demonstrated good ecological validity. These findings suggest the importance of evaluating multitasking capacities in patients diagnosed with schizophrenia in order to predict real world functioning., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Objectives: There is a large body of evidence to indicate that neurocognitive impairments in bipolar disorder (BD) may represent viable endophenotypes; however, a standard consensus-based battery of cognitive tests used to measure them is yet to appear. There is potential for a neurocognitive battery which was developed for use in the related disorder, schizophrenia - the MATRICS Consensus Cognitive Battery (MCCB) - to provide a consistent measurement tool with a standard to which the cognitive capacity of BD can be compared to other disorders. However, its suitability for capturing neurocognitive impairment in BD cohorts is not well established. Moreover, neurocognitive tests recently recommended by the International Society for Bipolar Disorders (ISBD) for inclusion in a consensus neurocognitive battery for BD have not been evaluated in the context of the MCCB. An evaluation of (i) the clinical efficacy of the MCCB and (ii) the tests recommended by the ISBD in a BD cohort were the aims of the current study., Methods: A total of 50 patients with BD (mean age = 38 years) and 52 healthy controls (mean age = 34 years) completed all of the MCCB subtests, in addition to the well-recognized Trail Making Test-Part B and the Colour-Word Stroop., Results: Multivariate analyses of variance of the MCCB domains revealed a significant group effect for overall cognition, and significantly reduced patient performance on speed of processing, working memory, and visual and verbal learning. A second multivariate analysis of variance using a newly created composite score called executive function, comprising scores on an existing MCCB subtest in addition to TMT-B and Colour-Word Stroop, revealed significant differences on this domain as well. Subgroup analysis indicated that there were no differences in any domain score performance between symptomatic and euthymic patients, or bipolar I and II disorder patient groups., Conclusions: Our findings suggest that the MCCB and two additionally recommended ISBD executive function measures form a promising consensus-based research tool for examining neurocognition in BD., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

A core symptom of schizophrenia is thought disorder (TD). The cognitive abilities of semantic processing and executive function are argued to be etiologically linked to TD. However, there has been no comprehensive investigation of neurocognition in TD to date. The neurocognitive profile of 58 schizophrenia patients and 48 healthy controls was examined using the MATRICS Consensus Cognitive Battery and the D-KEFS Color-Word Interference Test. TD patients performed more poorly than non-TD patients on the cognitive domains of Verbal Learning and Inhibition, reflective of semantic and executive function respectively, confirming their critical roles over and above other cognitive deficits in schizophrenia., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Psychiatrists pay more attention to the social functioning outcome of schizophrenia nowadays. How to evaluate the real world function among schizophrenia is a challenging task due to culture difference, there is no such kind of instrument in terms of the Chinese setting. This study aimed to report the validation of an ecologically valid performance-based everyday functioning assessment for schizophrenia, namely the Beijing Performance-based Functional Ecological Test (BJ-PERFECT). Fifty community-dwelling adults with schizophrenia and 37 healthy controls were recruited. Fifteen of the healthy controls were re-tested one week later. All participants were administered the University of California, San Diego, Performance-based Skill Assessment-Brief version (UPSA-B) and the MATRICS Consensus Cognitive Battery (MCCB). The finalized assessment included three subdomains: transportation, financial management and work ability. The test-retest and inter-rater reliabilities were good. The total score significantly correlated with the UPSA-B. The performance of individuals with schizophrenia was significantly more impaired than healthy controls, especially in the domain of work ability. Among individuals with schizophrenia, functional outcome was influenced by premorbid functioning, negative symptoms and neurocognition such as processing speed, visual learning and attention/vigilance., (© 2013 Elsevier Ireland Ltd. All rights reserved.)

Persons diagnosed with bipolar disorder often suffer from cognitive impairments. However, little is known concerning how these cognitive deficits impact their real world functioning. We developed a computerized real-life activity task, where participants are required to shop for a list of grocery store items. Twenty one individuals diagnosed with bipolar disorder and 21 matched healthy controls were administered the computerized shopping task. Moreover, the patient group was assessed with a battery of cognitive tests and clinical scales. Performance on the shopping task significantly differentiated patients and healthy controls for two variables: Total time to complete the shopping task and Mean time spent to consult the shopping list. Moreover, in the patient group, performance on these variables from the shopping task correlated significantly with cognitive functioning (i.e. processing speed, verbal episodic memory, planning, cognitive flexibility, and inhibition) and with clinical variables including duration of illness and real world functioning. Finally, variables from the shopping task were found to significantly explain 41% of real world functioning of patients diagnosed with bipolar disorder. These findings suggest that the shopping task provides a good indication of real world functioning and cognitive functioning of persons diagnosed with bipolar disorder., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Neurocognitive dysfunction is increasingly recognized as a prominent feature of bipolar disorder. Cognitive function seems to be impaired across different states of bipolar illness. Nervertheless, research that studies neuropsychological functioning in acute phases is scarce. Acutely ill patients have shown dysfunctions in several cognitive areas. We reviewed the literature on neuropsychological studies of acute phases to highlight neurocognitive deficits in mixed and pure mania. The results show dysfunctions in sustained attention that are significantly more important in mixed mania rather than in pure mania. Impulsive pattern of responding seems to characterize pure manic state. We also found impairments in processing speed, verbal and spatial learning/memory and executive functions, including cognitive flexibility, inhibitory control, conceptual reasoning, planning and problem solving. Disturbance in executive functioning seems to be more important in pure mania rather than mixed mania., (Copyright © 2013 Sociedade Brasileira de Farmacognosia. Published by Elsevier Masson SAS.. All rights reserved.)

Cognitive remediation (CR) for schizophrenia is a learning-based behavioural skills training intervention designed to enhance neuro and (or) social cognitive skills, with the ultimate goal of generalization to improve psychosocial outcomes. This review summarizes conceptual approaches to CR for schizophrenia and the evidence for efficacy in clinical research settings. Four issues are at the forefront of ongoing research: the identification of techniques that produce the largest cognitive change, delineation of techniques that enhance transfer of cognitive skills to functional skills, the identification of CR methods that can be personalized to meet the specific cognitive and functional needs of each individual, and, all the while, ensuring that when CR methods are developed in a research setting, they remain scalable for delivery in the larger clinical community. In response to these issues, 3 prominent research trends have emerged: the rise of a new generation of computerized restorative cognitive training, the integration of CR with skills training to promote generalization, and the application of techniques to enhance motivation and learning during CR. As data on the neural basis of learning in people with schizophrenia become available, new technologies that harness the ability of the brain to make sustainable, functional changes may be integrated within a therapeutic context that promotes a personalized approach to learning. The development of transportable and scalable methods of CR that maximize the ability of people with schizophrenia to improve cognition will help them achieve personal goals for recovery.

Background: Only 55% of anterior cruciate ligament-reconstructed (ACLR) athletes return to competitive sports. This brings into question the usefulness of current return to sport (RTS) criteria. High cognitive demand of sport environment clarifies the value of incorporating neurocognitive tests when making decisions regarding the time of RTS. This preliminary study aimed to compare the neurocognitive functions between healthy controls and ACLR male athletes who passed or failed RTS criteria. Methods: A total of 45 male football players, including 15 ACLR who passed RTS criteria, 15 ACLR who did not pass, and 15 healthy controls participated in this cross-sectional study. The Cambridge Neuropsychological Test Automated Battery was used to measure a battery of neurocognitive tasks, including speed of response, sustained attention, working memory, cognitive flexibility, and response inhibition. Results: The results revealed that compared with both the ACLR-passed and healthy groups, the ACLR-failed group showed greater values of 5-choice movement time (P =.02, P =.01, respectively) but lower values of stop signal reaction time (P =.03, P =.001, respectively) and proportion of successful stops variables (P =.02). In addition, compared with the healthy group, both the ACLR-failed and ACLR-passed groups indicated greater values in between errors (P <.001, P =.008, respectively) and reaction latency variables (P =.002, P =.01, respectively) but lower values of A′ (P <.001, P =.007, respectively), probability of hit (P <.001, P =.03, respectively), and percent correct trials variables (P =.006, P =.02, respectively). Conclusions: Our findings indicated deficits in neurocognitive functions in ACLR male athletes. In addition, poor performance in sustained attention, working memory, and cognitive flexibility measures observed in the ACLR-passed group highlighted the necessity for using a multimodal approach via implementation of neurocognitive measures in conjunction with the functional and muscular assessments when making RTS decisions. [ABSTRACT FROM AUTHOR]

Background Despite antiretroviral therapy (ART), human immunodeficiency virus (HIV)–associated neurocognitive impairment persists. We investigated the association between serum levels of mature brain-derived neurotrophic factor (mBDNF), precursor brain-derived neurotrophic factor (proBDNF), and neurocognitive changes over time among adults with HIV in sub-Saharan Africa, seeking to elucidate the interplay between neurotrophic factors and neurocognitive outcomes post-ART. Methods Utilizing data from the ACTG 5199 study in Johannesburg and Harare, serum mBDNF and proBDNF levels were measured via enzyme-linked immunosorbent assay. Neurocognitive performance was assessed at baseline and 24, 48, and 96 weeks using neuropsychological tests. The Friedman test and linear mixed-effects models were used to assess changes in mBDNF, proBDNF, and neurocognitive performance over time, accounting for individual variability and adjusting for multiple comparisons. Results Among 155 participants, there were significant cognitive improvements (P <.001) and a rise in mBDNF levels from baseline to 96 weeks. The proBDNF levels initially remained stable (P =.57) but notably increased by 48 weeks (P =.04). Higher mBDNF levels were positively associated with enhanced neurocognitive performance at 48 weeks (β =.16, P =.01) and 96 weeks (β =.32, P <.001). Similarly, higher proBDNF levels were positively associated with neurocognitive performance at 96 weeks (β =.25, P <.001). Conclusions This study highlights the significant association between serum BDNF levels and neurocognitive improvement post-ART in adults with HIV. However, more research is needed to replicate these findings, establish causal relationships, and explore whether BDNF-enhancing activities can improve neurocognitive outcomes in people with HIV. [ABSTRACT FROM AUTHOR]

Background: Neurocognitive functioning is an integral phenotype of 22q11.2 deletion syndrome relating to severity of psychopathology and outcomes. A neurocognitive battery that could be administered remotely to assess multiple cognitive domains would be especially beneficial to research on rare genetic variants, where in‐person assessment can be unavailable or burdensome. The current study compares in‐person and remote assessments of the Penn computerised neurocognitive battery (CNB). Methods: Participants (mean age = 17.82, SD = 6.94 years; 48% female) completed the CNB either in‐person at a laboratory (n = 222) or remotely (n = 162). Results: Results show that accuracy of CNB performance was equivalent across the two testing locations, while slight differences in speed were detected in 3 of the 11 tasks. Conclusions: These findings suggest that the CNB can be used in remote settings to assess multiple neurocognitive domains. [ABSTRACT FROM AUTHOR]

ObjectivesWe investigated the impact of culturally relevant social, educational, and language factors on cognitive test performance among Spanish speakers living near the US-Mexico border.MethodsParticipants included 254 healthy native Spanish speakers from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project (Age: M = 37.3, SD = 10.4; Education: M = 10.7, SD = 4.3; 59% Female). A comprehensive neuropsychological battery was administered in Spanish. Individual test scaled scores and T-scores (based on region-specific norms adjusted for age, education, and sex) were averaged to create Global Mean Scaled and T-scores. Measures of culturally relevant factors included a self-reported indicator of educational quality/access (proportion of education in Spanish-speaking country, quality of school/classroom setting, stopped attending school to work), childhood socioeconomic environment (parental education, proportion of time living in Spanish-speaking country, childhood socioeconomic and health status, access to basic resources, work as a child), and Spanish/English language use and fluency.ResultsSeveral culturally relevant variables were significantly associated with unadjusted Global Scaled Scores in univariable analyses. When using demographically adjusted T-scores, fewer culturally relevant characteristics were significant. In multivariable analyses, being bilingual (p = .04) and working as a child for one's own benefit compared to not working as a child (p = .006) were significantly associated with higher Global Mean T-score, accounting for 9% of variance.ConclusionsDemographically adjusted normative data provide a useful tool for the identification of brain dysfunction, as these account for much of the variance of sociocultural factors on cognitive test performance. Yet, certain culturally relevant variables still contributed to cognitive test performance above and beyond basic demographics, warranting further investigation.

Temporal stability of individual differences is an important prerequisite for accurate tracking of prospective relationships between neurocognition and real-world behavioral outcomes such as substance abuse and psychopathology. Here we report age-related changes and longitudinal test-retest stability (TRS) for the Neurocognition battery of the Adolescent Brain and Cognitive Development (ABCD) study, which included the NIH Toolbox (TB) Cognitive Domain and additional memory and visuospatial processing tests administered at baseline (ages 9-11) and two-year follow-up. As expected, performance improved significantly with age, but the effect size varied broadly, with Pattern Comparison and the Crystallized Cognition Composite showing the largest age-related gain (Cohen's d:.99 and.97, respectively). TRS ranged from fair (Flanker test: r = 0.44) to excellent (Crystallized Cognition Composite: r = 0.82). A comparison of longitudinal changes and cross-sectional age-related differences within baseline and follow-up assessments suggested that, for some measures, longitudinal changes may be confounded by practice effects and differences in task stimuli or procedure between baseline and follow-up. In conclusion, a subset of measures showed good stability of individual differences despite significant age-related changes, warranting their use as prospective predictors. However, caution is needed in the interpretation of observed longitudinal changes as indicators of neurocognitive development.

Among Latinx people living with HIV (PLWH), neurocognitive (NC) function, culture, and mental health impact medication adherence. Similarly, health beliefs and attitudes play a role in health care barriers and health behaviors. Research has not examined the effect that compromised neurocognition, sociocultural factors, and mental health have on health beliefs and attitudes. This is especially relevant for Latinx PLWH who are disproportionately impacted by HIV, given that sociocultural factors may uniquely impact HIV-related NC and psychological sequelae. This study investigated the associations between neurocognition, sociocultural factors, mental health, health beliefs, and health attitudes among Latinx HIV-seropositive adults. Within a sample of 100 Latinx PLWH, better verbal learning and executive functioning abilities were associated with more positive attitudes about the benefits of medications and memory for medications. In terms of sociocultural factors, higher English language competence was related to better self-reported memory for medications, and overall, higher US acculturation was associated with more positive attitudes toward health professionals. Depressive symptomatology was negatively associated with attitudes toward medications and health professionals, as well as with self-reported memory for medications. These findings highlight the important interplay between NC, sociocultural, psychological factors, and health beliefs among Latinx PLWH. Adherence intervention strategies and suggestions for dispensing medical information are presented for clinicians and health care practitioners. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Neurocognitive and social cognitive abilities are important contributors to functional outcomes in schizophrenia spectrum disorders (SSDs). An unanswered question of considerable interest is whether neurocognitive and social cognitive deficits arise from overlapping or distinct white matter impairment(s). Study Design We sought to fill this gap, by harnessing a large sample of individuals from the multi-center Social Processes Initiative in the Neurobiology of the Schizophrenia(s) (SPINS) dataset, unique in its collection of advanced diffusion imaging and an extensive battery of cognitive assessments. We applied canonical correlation analysis to estimates of white matter microstructure, and cognitive performance, across people with and without an SSD. Study Results Our results established that white matter circuitry is dimensionally and strongly related to both neurocognition and social cognition, and that microstructure of the uncinate fasciculus and the rostral body of the corpus callosum may assume a "privileged role" subserving both. Further, we found that participant-wise estimates of white matter microstructure, weighted by cognitive performance, were largely consistent with participants' categorical diagnosis, and predictive of (cross-sectional) functional outcomes. Conclusions The demonstrated strength of the relationship between white matter circuitry and neurocognition and social cognition underscores the potential for using relationships among these variables to identify biomarkers of functioning, with potential prognostic and therapeutic implications. [ABSTRACT FROM AUTHOR]

BackgroundCollaborative data sharing between research groups provides an opportunity to explore the basis for the heterogeneity in cognitive training outcomes reported in the schizophrenia literature. The current analyses focused on the contribution of site and participant characteristics to these heterogeneous outcomes.MethodsData from two independent studies, from New York (NY) and Los Angeles (LA), were combined to yield a sample of 132 outpatient adults with schizophrenia/schizoaffective disorder. While similar treatment doses, cognitive exercises and outcome measures were used, sites differed in use of coaching, group discussion and compensation. Between-site differences in participant demographic and baseline clinical characteristics were tested. Regression examined predictors of change in cognition (MCCB) and functional capacity (UPSA) which could explain site differences in treatment effects.ResultsMedium to large treatment effect size differences in MCCB and UPSA favored the NY site over LA. When the studies were combined, the effect of site was significant for both outcomes with a medium effect size difference. After controlling for background characteristics, the effect of site was reduced for both outcomes, but remained significant for cognition. Improvement in UPSA was associated with better baseline MCCB (p

Memantine's benefits in Alzheimer's disease (AD) are modest and heterogeneous. We tested the feasibility of using sensitivity to acute memantine challenge to predict an individual's clinical response. Eight participants completed a double-blind challenge study of memantine (placebo versus 20 mg) effects on autonomic, subjective, cognitive, and neurophysiological measures, followed by a 24-week unblinded active-dose therapeutic trial (10 mg bid). Study participation was well tolerated. Subgroups based on memantine sensitivity on specific laboratory measures differed in their clinical response to memantine, some by large effect sizes. It appears feasible to use biomarkers to predict clinical sensitivity to memantine.

Background: Grey matter (GM) reduction is a consistent observation in established late stages of schizophrenia, but patients in the untreated early stages of illness display an increase as well as a decrease in GM distribution relative to healthy controls (HC). The relative excess of GM may indicate putative compensatory responses, though to date its relevance is unclear. Methods: 343 first-episode treatment-naïve patients with schizophrenia (FES) and 342 HC were recruited. Multivariate source-based morphometry was performed to identify covarying 'networks' of grey matter concentration (GMC). Neurocognitive scores using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and symptom burden using the Positive and Negative Symptoms Scale (PANSS) were obtained. Bivariate linear relationships between GMC and cognition/symptoms were studied. Results: Compared to healthy subjects, FES had prominently lower GMC in two components; the first consists of the anterior insula, inferior frontal gyrus, anterior cingulate and the second component with the superior temporal gyrus, precuneus, inferior/superior parietal lobule, cuneus, and lingual gyrus. Higher GMC was seen in adjacent areas of the middle and superior temporal gyrus, middle frontal gyrus, inferior parietal cortex and putamen. Greater GMC of this component was associated with lower duration of untreated psychosis, less severe positive symptoms and better performance on cognitive tests. Conclusions: In untreated stages of schizophrenia, both a distributed lower and higher GMC is observable. While the higher GMC is relatively modest, it occurs across frontoparietal, temporal and subcortical regions in association with reduced illness burden suggesting a compensatory role for higher GMC in the early stages of schizophrenia. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is becoming increasingly common in adolescents and seriously affects their physical and mental health, and it is also a major risk factor for suicide among adolescents. NSSI has now become a public health issue of general concern; however, the identification of cognitive dysfunction in NSSI is still based on neuropsychological cognitive assessment and subjective questionnaire assessment, with a lack of objective evaluation indicators. As a method for studying the cognitive neural mechanism of NSSI, electroencephalography is a reliable tool for finding objective biomarkers of NSSI. This article reviews the recent research on electrophysiology associated with cognitive dysfunction in adolescents with NSSI. [ABSTRACT FROM AUTHOR]

Background Childhood brain tumor survivors are at high risk of late effects, especially neurocognitive impairment. Limited data are available examining neurocognitive function and associations with quality of life (QoL) in childhood brain tumor survivors. Our aim was to examine neurocognitive function in childhood brain tumor survivors, and associations with QoL and symptom burden. Methods Five–year survivors of brain tumors over the age of 15 were identified in the Danish Childhood Cancer Registry (n = 423). Eligible and consenting participants completed neuropsychological tests and questionnaires assessing QoL, insomnia, fatigue, anxiety, and depression. Survivors treated with radiation (n = 59) were statistically compared with survivors not treated with radiation (n = 102). Results In total, 170 survivors participated (40.2% participation rate). Sixty-six percent of the survivors who completed neurocognitive tests (n = 161) exhibited overall neurocognitive impairment. Survivors treated with radiation, especially whole-brain irradiation, exhibited poorer neurocognitive outcomes than survivors not treated with radiation. Neurocognitive outcomes for survivors treated with surgery were below normative expectations. Furthermore, a number of survivors experienced significant fatigue (40%), anxiety (23%), insomnia (13%), and/or depression (6%). Survivors treated with radiation reported lower quality of life (QoL) and higher symptom burden scores than survivors not treated with radiation; particularly in physical functioning, and social functioning with symptoms of fatigue. Neurocognitive impairment was not associated with QoL or symptom burden. Conclusions In this study, a majority of the childhood brain tumor survivors experienced neurocognitive impairment, reduced QoL, and high symptom burden. Although not associated with each other, it is apparent that childhood brain tumor survivors experience not only neurocognitive dysfunction but may also experience QoL impairments and significant symptom burden. [ABSTRACT FROM AUTHOR]

Background: Once psychosis has set in, it is difficult for patients to achieve full recovery. Prevention of psychosis and early intervention are promising for improving the outcomes of this disorder. In the last two decades, neurocognition has been studied as a biomarker for clinical-high risk for psychosis (CHR-P). However, neurocognitive functioning has been under-investigated in adolescents. Methods: We enrolled 116 adolescents from 12 to 17 years old (mean = 15.27, SD = 1.56; 76 females). This 3-year cohort study aimed to identify differences in neurocognitive and overall functioning in three groups of adolescent patients divided according to the semi-structured interview Comprehensive Assessment of At-Risk Mental States (CAARMS): adolescents with established psychosis, adolescents with CHR-P, and adolescents not meeting either criteria (non-CHR-P). To differentiate the profiles, clinicians administered cognitive evaluation and neuropsychological tasks. Moreover, they filled in scales to assess their global, social, and role functioning and a questionnaire to assess the severity of the disease. Results: We made a between-group comparison on neurocognitive measures and found that the CHR-P and the psychosis groups differed in processing speed (TMT-A; p =.002 in BVN categorial fluency (p =.018), and Rey–Osterrieth complex figure drawing from memory task (p =.014), with psychosis group showing worse performance. No differences emerged between non-CHR-P and CHR-P (p =.014) individuals. CHR-P had better functioning than the psychosis group but worse than the non-CHR-P one. Conclusions: These results confirm that neurocognition can be a helpful biomarker in identifying specific subgroups of adolescents with emerging psychopathology and help clinicians develop stratified preventive approaches. [ABSTRACT FROM AUTHOR]

Background: Lower levels of education have been associated with the development of psychosis. Investigating educational achievement in the first episode of psychosis (FEP) patients may shed light on the origins of the alterations and on the variability of outcomes in psychotic disorders. Methods: Education achievement was explored in a large sample (n = 659) of FEP patients enrolled in programa de atención a fases iniciales de psicosis (PAFIP), a research and assistance program conducted in Spain. Patients were stratified according to the Spanish educational system according to their attendance in primary (low), secondary (medium) or university studies (high). The three groups were compared on available premorbid, clinical and neuropsychological variables. A subgroup of patients (n = 209), comprising the 10-year follow-up PAFIP cohort, were again compared. Results: Overall, 49% and 37% of FEP patients had low and medium levels of education, respectively. In total, 13% of the patients with a higher level of education were more frequently women (64%) and older at illness onset (36 years old), reported better premorbid adjustment, presented less severe positive symptoms and better functioning; and showed higher premorbid intelligence quotient and better performance on all the explored cognitive domains. Ten years later the FEP patients in the medium- and high-education groups had good global functioning and a neurocognitive performance within the normal limits. Conclusions: Higher education is associated with better initial conditions and more favourable outcomes after an FEP. Sharing this information with the world's educational systems is essential to targeting resources and designing innovative programs or strategies to compensate for student difficulties. [ABSTRACT FROM AUTHOR]

ObjectiveThe purpose of this study is to examine the association between verbal learning, fluency, and processing speed with anxious depression symptomatology (ADS) among diverse Hispanics. We hypothesized an inverse association of anxious depression with neurocognition among Hispanics of different heritage.DesignData are from the Hispanic Community Health Study/Study of Latinos. The sample included 9,311participants aged 45-74 years (mean: 56.5 years). A latent class analysis of items from the Center for Epidemiological Studies for Depression scale and the Spielberger Trait Anxiety Inventory was used to derive an anxious depression construct. Neurocognitive measures included scores on the Brief Spanish English Verbal Learning Test (B-SEVLT, learning and recall trials), Word Fluency (WF), Digit Symbol Substitution (DSS) test, and a Global Cognitive Score (GCS). We fit survey linear regression models to test the associations between anxious depression symptomatology and cognitive function. We tested for effect modification by sex, Hispanic heritage, and age groups.ResultsAmong men, 71.6% reported low, 23.3% moderate, and 5.1% high ADS. Among women, 55.1% reported low, 33.2% moderate, and 11.8% high ADS. After controlling for age, sex, sociodemographic characteristics, cardiovascular risk factors and disease, and antidepressant use, we found significant inverse associations between moderate and high anxious depression (ref:low) with B-SEVLT learning and recall, DSS and GCS. Moderate, but not high, anxious depression was inversely associated with WF. Associations were not modified by sex, Hispanic heritage, or age.ConclusionsIncreased anxious depression symptomatology is associated with decreased neurocognitive function among Hispanics. Longitudinal studies are needed to establish temporality and infer if negative emotional symptoms precede cognitive deficits.

Cognitive deficits have an important role in the neurodevelopment of schizophrenia and other psychotic disorders. However, there is a continuing debate as to whether cognitive impairments in the psychosis prodrome are stable predictors of eventual psychosis or undergo a decline due to the onset of psychosis. In the present study, to determine how cognition changes as illness emerges, we examined baseline neurocognitive performance in a large sample of helping-seeking youth ranging in clinical state from low-risk for psychosis through individuals at clinical high-risk (CHR) for illness to early first-episode patients (EFEP). At baseline, the MATRICS Cognitive Consensus battery was administered to 322 individuals (205 CHRs, 28 EFEPs, and 89 help-seeking controls, HSC) that were part of the larger Early Detection, Intervention and Prevention of Psychosis Program study. CHR individuals were further divided into those who did (CHR-T; n = 12, 6.8%) and did not (CHR-NT, n = 163) convert to psychosis over follow-up (Mean = 99.20 weeks, SD = 21.54). ANCOVAs revealed that there were significant overall group differences (CHR, EFEP, HSC) in processing speed, verbal learning, and overall neurocognition, relative to healthy controls (CNTL). In addition, the CHR-NTs performed similarly to the HSC group, with mild to moderate cognitive deficits relative to the CTRL group. The CHR-Ts mirrored the EFEP group, with large deficits in processing speed, working memory, attention/vigilance, and verbal learning (>1 SD below CNTLs). Interestingly, only verbal learning impairments predicted transition to psychosis, when adjusting for age, education, symptoms, antipsychotic medication, and neurocognitive performance in the other domains. Our findings suggest that large neurocognitive deficits are present prior to illness onset and represent vulnerability markers for psychosis. The results of this study further reinforce that verbal learning should be specifically targeted for preventive intervention for psychosis.

Background: Prior studies have shown high heritability estimates regarding within-function transmission of neurocognition, both in healthy families and in families with schizophrenia but it remains an open question whether transmission from parents to offspring is function specific and whether the pattern is the same in healthy families and families with schizophrenia or bipolar disorder. We aimed to characterize the transmission of intelligence, processing speed, and verbal working memory functions from both biological parents to their 7-year-old offspring in families with parental schizophrenia, bipolar disorder, and population-based control parents.Methods: The population-based cohort consists of 7-year-old children with one parent diagnosed with schizophrenia (n = 186), bipolar disorder (n = 114), and of parents without schizophrenia or bipolar disorder (n = 192). Children and both parents were assessed using identical, age-relevant neurocognitive tests of intelligence, verbal working memory, and processing speed.Results: In multiple regression analyses children's intelligence, verbal working memory, and processing speed scores were significantly associated with the corresponding parental cognitive function score. All associations from parents to offspring across functions were non-significant. No significant parental cognitive function by group interaction was observed.Conclusion: Transmissions of intelligence, processing speed, and verbal working memory from parents to offspring are function specific. The structure of transmission is comparable between families with schizophrenia, families with bipolar disorder and families without these disorders. [ABSTRACT FROM AUTHOR]