搜索结果：Journal of clinical and experimental neuropsychology

The deterioration of autobiographical memory (AM) and autonoetic consciousness is central in Alzheimer's Disease (AD). Here, we investigated the presence of AM alterations in a potential preclinical stage of AD known as Subjective Cognitive Decline (SCD), characterized by a self-reported worsening in cognitive functioning without an objective cognitive impairment. Considering the key role of spatial and temporal components in episodic features of AM, we further hypothesized that alterations in such components may be highlighted in SCD, and investigated possible modifications in these functions with tasks tapping environmental navigation and duration processing. Finally, the level of cognitive complaints was also considered a factor that may modulate performance. Performance of 31 individuals with SCD was compared with that of 31 healthy control participants matched for age, gender, and education. AM was assessed using the Autobiographical Interview and the Autobiographical Fluency Task (AFT). Environmental navigation was investigated using a battery assessing route, landmark, and survey knowledge, and landmark ordering. Temporal processing was assessed with computerized tasks investigating retrospective and prospective duration processing. SCD produced more items in the personal semantics condition of the AFT compared with healthy controls, while showing reduced performance in landmark recognition and survey knowledge. When considering cognitive complaints, which are known to play a role in modulating performances in SCD, results showed a positive association between scores on the Cognitive Failure Questionnaire and scores on the semantic condition of the AFT, and a significant negative correlation between scores on the Cognitive Failure Questionnaire and performance in retrospective duration processing. Findings suggest that subtle alteration of AM and spatiotemporal processing can be identified in SCD, and that the level of cognitive complaints may be a relevant factor in modulating spatiotemporal processing and autobiographical memory in this population.

Anosognosia for aphasia is a condition in which patients may show reduced awareness of their language deficits. Statistical biases that may arise when people with very mild or very severe aphasia are included in group studies have raised concerns about the validity of self-report measures. Given these concerns, the interplay of cognitive biases such as the Dunning-Kruger effect (DKE) should be considered when evaluating awareness of language deficits. A sample of 66 individuals with a unilateral left-hemisphere brain lesion completed a standardized aphasia assessment (the Aachen Aphasia Test; AAT) and an awareness measure (the Visual Analogue Test Assessing Anosognosia for Language Impairment; VATA-L) to evaluate the frequency and extent of anosognosia and overestimation of language difficulties, and to evaluate the possible impact of statistical biases. The results showed a significant percentage (37.9%) of patients with pathological or borderline distorted awareness, with a tendency to underestimate (25.8%) rather than overestimate (6.1%) language deficits. No association was found between aphasia severity and awareness levels in our sample, even when individuals with very mild or very severe aphasia were accounted for. Findings suggest that unawareness for language difficulties cannot be solely attributed to statistical biases, and that aphasic individuals with a unilateral left-hemisphere brain lesion may not be fully aware of their language difficulties. Research Question(s) or Topics(s): To examine the frequency and extent of over- and underestimation of language difficulties in aphasic patients with left-hemisphere brain damage, and to evaluate the potential influence of statistical biases, such as the DKE, on awareness measures.Main Findings: We found several cases of anosognosia and overestimation of deficits, with a tendency to underestimate language deficits (i.e., anosognosia). There was no significant association between aphasia severity and awareness levels, even after controlling for statistical biases, indicating that unawareness cannot be solely attributed to statistical artifacts.Study Contributions: This study demonstrates that distortions of awareness can occur following unilateral left-hemisphere brain damage, challenging the traditional view that anosognosia is confined to right-hemisphere or bilateral brain lesions. The findings highlight the importance of routinely assessing awareness in aphasic patients due to its variability and implications for rehabilitation strategies and patient engagement.

Recent advances in biomarker testing for Alzheimer's disease (AD), most notably the introduction of blood-based biomarkers (BBMs), have prompted a revision in diagnostic criteria for AD. In comparison to other established neurodiagnostic testing (i.e. amyloid positron emission tomography [PET] and cerebral spinal fluid [CSF] assays), AD BBMs offer a scalable, low-cost, and accessible method to aid in the diagnosis of AD which, in turn, may offer more expedient intervention. Despite this headway in AD diagnosis, several concerns about the clinical implementation of BBMs remain--and specifically, who should be receiving them. Palmqvist et al. (2025) recently published clinical practice guidelines to clarify the use of BBMs in specialty care settings; however, there remains variability in the administration and interpretation of test results to patients. As BBMs expand, it is critical that clinicans do not overlook the consideration of alternative causes of cognitive decline, which can lead to misdiagnosis of AD. This article expands on current clinical guidelines for biomarker testing, discussing ethical and practical considerations of AD BBMs, and offering a shared decision-making (SDM) framework to encourage patient-centered care when considering appropriateness of BBMs in specialty care settings. The framework includes 1) patient education, 2) clarifying patient values, and 3) offering clinical guidance. Future directions of AD BBMs and health disparities are also discussed.

Understanding the risk factors that associate with early cognitive decline in Alzheimer's disease (AD) is important to identify high-risk individuals and initiate early intervention. Existing studies show that APOEε4, systemic inflammation, and diabetes may play roles in cognitive decline, but the extent to which these factors interact with each other remains unclear. Our objective was to examine the main effects and higher-order interactions between APOEε4, high sensitivity-C-reactive protein (hs-CRP) as a measure of systemic inflammation, and diabetes on domain-specific measures of cognitive function in two ancillary studies of post-menopausal women from the Women's Health Initiative (WHI). We identified 2979 cognitively unimpaired women from the WHI Epidemiology of Cognitive Health Outcomes and the WHI Memory Study of Younger Women with cognitive follow-up of up to 13 years. Linear mixed-effects models examined the main and interactive effects of APOEε4, hs-CRP, and diabetes on longitudinal changes in the personal communication for Cognitive Status-modified Test (TICS-m), East Boston Memory Test (immediate and delayed; EBMT), Oral Trail Making Test (OTMT), Verbal Fluency Test (VF-A), Digit Span Test Backwards (DST-backward), and the California Verbal Learning Test (CVLT). All models were adjusted for baseline age, education, body mass index, the WHI randomization arm, and the cohort. APOEε4 carriers had steeper cognitive decline in TICS-m, EBMT (immediate and delayed), VF-A, and CVLT scores relative to non-carriers. Higher levels of hs-CRP were associated with steeper cognitive decline in the DST-backwards scores. There was no association of diabetes or any evidence of interactive effects on cognitive decline in our study. In this large longitudinal study of post-menopausal women, our findings support the hypothesis that genetic risk and systemic inflammation independently influence cognitive decline, but there was no evidence of synergistic effects in postmenopausal women. Further research is needed to elucidate the mechanistic pathways underlying these associations with cognitive decline.

Spontaneous speech is commonly disrupted in persons with Alzheimer's disease (AD) and/or Alzheimer's clinical syndrome (ACS). Importantly, different aspects of speech (e.g. formulaic versus more novel or flexible speech) place different demands on distinct cognitive systems. Formulaic language may rely on automatized procedural processes, while more novel or diverse speech requires more flexible lexical-semantic processes associated with the subsystems of declarative memory. Given that AD/ACS are associated with impaired declarative processes and relatively spared procedural processes, we predicted that individuals with ACS may show increased reliance on formulaic language along with reduced diversity in speech. We analyzed the spontaneous speech of 81 individuals with ACS (aged 56-88) and 61 healthy controls (aged 47-80) who completed a picture description task using computational tools for the analysis of formulaic language (operationalized as proportion of frequent trigrams produced and mutual information score of trigrams) and novel language (operationalized as root type-token ratio, measure of textual lexical diversity, and semantic diversity). Across all measures, individuals with ACS produced significantly more formulaic language than control participants and significantly less novel language than control participants, with small-to-medium overall model effect sizes. Machine learning classifiers trained on these patterns of formulaic and novel language distinguished between controls and individuals with ACS with reasonable accuracy, sensitivity, and specificity. The spontaneous speech of individuals with ACS contains more formulaic language and less novel language than that of healthy controls, consistent with the Dual-Process Model. These differences may have clinical relevance and warrant further investigation. Keywords: Alzheimer's Disease, Alzheimer's clinical syndrome, formulaic language, lexical diversity, spontaneous speech.

Self-reported cognitive and affective complaints are crucial in diagnosing neuropsychiatric conditions like adult attention-deficit/hyperactivity disorder (ADHD). While common, these complaints often reflect factors beyond measurable cognitive deficits, highlighting the need for validated assessment tools. This study uses a transdiagnostic approach to (1) explore factor models underlying self-reported cognitive and affective problems and (2) examine how these complaints relate to objective neuropsychological performance, aiming to improve clinical assessment and understanding. Data were collected from 808 adolescents and adults seeking support for self-perceived learning and co-occurring mental health challenges from the Finnish Rehabilitation Foundation between 2014 and 2021. Self-reported cognitive and affective (depression and anxiety) complaints were assessed with the Questionnaire of Learning and Mental Health Problems (KOMO), and neuropsychological test data were additionally obtained from a subgroup of 70 participants. The structure of cognitive and affective complaints and their correlations with neuropsychological test performance were examined using exploratory and confirmatory factor analyses. The model best explaining the data included a general factor for affective complaints but correlated factors for cognitive complaints. In that model, transdiagnostic affective symptoms correlated more strongly with cognitive complaints (r = .36‒.72) than specific depressive symptoms (r = .05‒.10). Mathematics and visuospatial-visuomotor complaints showed the strongest negative associations with neuropsychological test performance, while attention-executive function complaints had unexpected positive associations with performance in several cognitive domains. This study replicates the transdiagnostic structure of affective problems and suggests that cognitive complaints do not fit a comparable general factor structure. Findings highlight the complexity of self-reported cognitive issues - particularly those related to attention and executive function - and underscore the need for comprehensive assessments that go beyond self-report measures.

The historical underpinnings of the Houston Conference Guidelines (HCG) specifying educational, supervision, and training standards for clinical neuropsychology are reviewed from a personal perspective. This viewpoint comes from developing and directing doctoral and post-doctoral level training programs in clinical neuropsychology that followed the HCG at two major universities from 1977 to 2018, directly observing the importance of such specialization training for the field of clinical neuropsychology. The criteria outlined in the original HCG have proven their importance and the test of time for creating the structure that defines the clinical neuropsychology discipline, including who can designate their training as meeting these defining criteria for the practice of clinical neuropsychology. Through the lens of history, the rationale is outlined as to why these standards need to remain as originally specified in the HCG document.

The Trail Making Test (TMT) is an important test when assessing for cognitive difficulties in people with Parkinson's Disease (PD). However, the pencil-and-paper format can be susceptible to administration and scoring errors and may disproportionately reflect motor impairments rather than cognitive performance. The current study sought to evaluate the reliability and diagnostic accuracy of two novel computerized versions of the TMT: iTMT-Tap and iTMT-Drag. This study used a quasi-experimental diagnostic accuracy design, and included 34 healthy controls, 28 people with Parkinson's disease with normal cognition (PD-NC), and 31 people with Parkinson's disease mild cognitive impairment (PD-MCI). Participants were administered a short battery of cognitive tests, including three counterbalanced versions of the TMT (traditional TMT, iTMT-Tap & iTMT-Drag). Additionally, the iTMT-Tap and iTMT-Drag were readministered following a brief break. Both the iTMT-Tap and iTMT-Drag demonstrated adequate convergent validity and retest reliability and achieved acceptable classification accuracy for identifying PD-MCI. The current study identified hidden indices of measurement which may minimize administration time or the confounding impact of motor functioning, and these indices achieved fair diagnostic accuracy also. The results of this research suggest that the iTMT-Tap and iTMT-Drag may be a valid substitute for the traditional TMT, and subject to further validation, could be a useful addition to clinical practice. Recommendations for future research and subsequent clinical deployment are discussed.

This study characterizes the attention and executive functioning (EF) profile of school-age children with congenital heart disease (CHD) using a construct-based approach. It was hypothesized that difficulties in specific attention/EF constructs would be evident, and degree of difficulty would vary by CHD complexity and neurodevelopmental diagnosis. Demographic, medical, and neuropsychological data were retrospectively examined from 154 children with CHD aged 6-16 years seen for neuropsychological evaluation between October 2013 and October 2024. Exploratory factor analysis yielded six attention/EF constructs. Constructs were compared to normative means. Frequency of impairment was calculated. CHD complexity and DSM-5 diagnosis on constructs were analyzed with multivariate analysis of variance. All attention/EF construct scores were significantly lower than normative means. Frequency of impairment varied across constructs; one-third of participants had exceptionally low and below average performances within processing speed, attention, and impulse control constructs. Clinical or subclinical functional inattention and hyperactivity was reported in half of participants, with clinical symptoms reported in one-fourth. Children with simple CHD had worse impulse control and functional inattention and hyperactivity compared to those with complex CHD. Those with only a neurodevelopmental diagnosis performed lower than those with no DSM-5 diagnosis. Children with CHD had attention/EF deficits across multiple constructs (i.e. skill areas), although frequency and severity of impairment varied by construct. This suggests children with CHD have a neurobehavioral profile that may not fully align with traditional diagnostic categories, which has implications both for diagnosis and intervention. Greater difficulties observed in children with simple CHD emphasize the importance of neurodevelopmental monitoring of all CHD types. Neurodevelopmental diagnosis was associated with lower processing speed, but this skill is not a core diagnostic feature of a neurodevelopmental disorder. Thus, consideration of dimensional diagnostic approaches within a clinical patient population such as CHD is warranted.

Psychopathology and cognitive impairment are common consequences of moderate-severe traumatic brain injury (TBI), but their interrelationships remain poorly understood. Clarifying these relationships is important for understanding cognition's role in post-TBI psychopathology and for informing targeted, holistic assessment and treatment strategies. Traditional categorical approaches to psychiatric diagnosis have produced inconsistent results. The recently developed Hierarchical Taxonomy of Psychopathology Following TBI (HiTOP-TBI) model, a transdiagnostic-dimensional framework, was applied to examine associations between psychopathology and cognitive functioning. Ninety-nine adults with moderate-severe TBI participated (Mage = 50.86 years; 72% male; Mtime post-injury  = 14.6 years,SD = 8.2; MGCS = 8.03; MPTA = 24.3 days). Psychopathology was assessed using self-report questionnaires completed predominantly online (96%). Cognitive performance was assessed via telephone-administered tasks. Linear regressions examined associations between ten hierarchically organizedHiTOP-TBI dimensions (one general factor, two broad internalizing and externalizing spectra, seven lower-order factors) and cognitive measures, with false discovery rate correction applied. After correction, higher scores (indicating greater psychopathology) on the HiTOP-TBI dimensions of Externalizing Problems, Rigid Constraint, and Self-Harm and Psychoticism were associated with poorer performance on verbal encoding and the episodic memory domain (encompassing both immediate and delayed recall). In comparison, General Problems, Internalizing Problems, Somatic Symptoms, Detachment, Compensatory and Phobic Reactions, Dysregulated Negative Emotionality, and Harmful Substance Use, were notsignificantly associated with cognitive functioning, after correction. Applying the transdiagnostic, dimensional HiTOP-TBI framework, we identified several associations between psychopathology and cognitive functioning after moderate-severe TBI. Verbal encoding and memory were most consistently implicated, particularly within externalizing domains. Findings highlight the importance of holistic neuropsychological formulation and integrative interventions aimed at improving both emotional and cognitive outcomes in TBI and demonstrate the value of transdiagnostic approaches in neuropsychology research and practice.

The altered gut microbiota substantially impacts the onset and progression of Alzheimer's disease (AD) and Parkinson's disease (PD), the two most widely studied neurodegenerative conditions. Microbiome-derived metabolites have been increasingly associated with disease onset, progression, and therapeutic targets in neurodegenerative disorders. Exploring the diagnostic and therapeutic implications of gut microbiome-derived biomarkers is critical to advancing our understanding and management of neurodegeneration. We systematically reviewed both clinical and preclinical studies published from 2010 to 2025. Studies examining gut microbiota composition, microbial-derived metabolites, or therapeutic interventions targeting the gut microbiome were included. Identification of gut microbiome alterations, discovery of microbial or metabolite-based biomarkers, association with disease onset or progression, and/or therapeutic effects on cognitive, neurological, or inflammatory outcomes were evaluated. Short-chain fatty acids(SCFAs) such as butyrate and acetate were found to be noninvasive biomarkers in patients with Alzheimer's disease (AD), mild cognitive impairment (MCI), and Parkinson's disease (PD). Lower SCFA levels correlated with cognitive decline. Diagnostic accuracy improved when SCFA combinations were used, with AUCs ranging from 0.75 to 0.87. Trimethylamine N-oxide(TMAO) levels showed inconsistent associations, with both elevated and reduced levels linked to disease risk. Therapeutic approaches targeting gut microbiota, including probiotics, prebiotics, dietary changes, and fecal microbiota transplantation, demonstrated cognitive benefits and modulation of gut-brain signaling pathways. Overall, gut-derived biomarkers offer a promising avenue for early diagnosis and novel therapeutic approaches in AD and PD, while acknowledging that evidence in other neurodegenerative diseases remains limited through modulation of the gut-brain axis.

The diagnosis of specific learning disorders (SLDs) in adults has increased substantially over the past two decades, particularly within selective postsecondary and professional training settings. Part II of this paper examines why adult SLD diagnosis is especially vulnerable to error and bias, despite diagnostic criteria requiring substantial, developmentally grounded academic impairment. We synthesize empirical research from neuropsychology, education, and psychometrics to identify systematic sources of diagnostic distortion in adult SLD assessment. Particular emphasis is placed on statistical artifacts (e.g. restriction of range), base-rate neglect, contextual performance effects, performance validity, reliance on self-report, and the misapplication of sociostructural frameworks to clinical decision-making. To combat overdiagnosis and ground diagnosis in empirically-supported practices, we propose a four-step diagnostic framework for first time diagnosis of SLD in adults: 1) Documented academic achievement below at least the 16th percentile relative to the general population norms; 2) Clear evidence of onset in early school years, including impairment when scaffolding and supports are removed; 3) Evidence that academic difficulties persisted despite adequate educational opportunity and, when available, targeted intervention; and 4) Exclusion of contextual, motivational, neurological/medical, language, or instructional explanations. Accurate diagnosis of SLD in adulthood requires population-referenced criteria, corroborated evidence of childhood onset, objective demonstration of current academic impairment, systematic exclusion of alternative explanations, and assessment of performance credibility. Adoption of a structured, evidence-based diagnostic framework is essential to preserving the scientific validity, ethical application, and equitable use of SLD diagnoses in adult educational and professional settings.

This paper examines how the concept of dyslexia, a problem that was once considered to be both rare and highly salient, has now been broadened to such an extent that many adults with successful educational histories, and without any history of significant reading difficulty, receive a dyslexia diagnosis only after having progressed to higher education, training, or employment. It is argued that the basis of the problem lies largely in conceptual and scientific misunderstandings. While there is a wide consensus that dyslexia represents a severe, complex, and persistent difficulty in learning to decode text, many have placed undue emphasis upon a wide variety of cognitive processes as diagnostic indicators. The primary error stems from conflating the greater likelihood of finding such difficulties in groups of struggling readers with the belief that these can be adjudged to be markers of dyslexia in the case of a given individual. This misconception has been exacerbated by a growing emphasis upon self-reported difficulties and the use of lived experience as primary means of understanding the nature of the condition. The dangers that result for scientific advance and for evidence-led educational policy and practice are highlighted. It is contended that the expansion of the dyslexia construct, and the misuse of assessment data, particularly when employed with adults, has in part been fueled, not by scientific research, but by the misunderstandings, interests, and motivations of those receiving and providing diagnostic services. Illustrative examples from the domains of adult higher education, medical training, and employment tribunals are offered as illustration.

Information processing speed (IPS) is frequently impaired in people with multiple sclerosis (PwMS) and can potentially interfere with functioning in other cognitive domains. A relationship between IPS and visuospatial memory has been shown, but the impact of IPS on the separate components of visuospatial memory remains unclear. In this study, we aim to investigate the association between IPS impairment and encoding, active and passive retrieval, and learning indices of visuospatial memory in PwMS. Cross-sectional data from 92 PwMS with cognitive complaints and 29 matched healthy controls (HCs) were retrospectively analyzed. IPS and visuospatial memory were measured using the Symbol Digit Modalities Test (SDMT) and the Brief Visuospatial Memory Test - Revised (BVMT-R), respectively. Hierarchical regression analyses were performed to assess the predictive value of IPS impairment (z-score &#x2264;-1.5) for visuospatial encoding, active and passive retrieval, as well as learning indices scores. In total, 47.8% of PwMS were impaired on the SDMT. IPS impairment significantly predicted lower performance on the second (&#xdf;&#x2009;=&#x2009;-0.26, p&#x2009;=&#x2009;0.011) and third (&#xdf;&#x2009;=&#x2009;-0.29, p&#x2009;=&#x2009;0.003) learning trials, active retrieval (&#xdf;&#x2009;=&#x2009;-0.33, p&#x2009;<&#x2009;0.001), and learning index (&#xdf;&#x2009;=&#x2009;-0.28, p&#x2009;=&#x2009;0.003) of the BVMT-R in PwMS. No significant association was found between IPS impairment and the initial learning and passive retrieval scores. In HCs, no association between IPS and BVMT-R performance was found. PwMS with IPS impairment perform worse on visuospatial learning and memory, particularly in the later encoding phases and active retrieval of information. These findings highlight the importance of taking IPS impairment into account when interpreting visuospatial memory performance in MS.

Verbal fluency tests have seen exponential growth in research and clinical practice in recent years, yet little is known about the distribution of grammatical categories spontaneously produced in phonemic fluency tasks. This study examined the distribution of nouns, verbs, and adjectives in phonemic fluency performance in a large Greek sample from the general population and explored their associations with age and education. Greek is particularly suited to this investigation because it has distinct word forms for nouns, verbs, and adjectives. The phonemic fluency productions of 427 persons aged 16 to 87&#x2009;years without known pathology, representing a wide range of educational backgrounds, were classified as nouns, verbs, adjectives, or other. Verb-noun and adjective-noun ratios were computed and compared to ratios derived from corpus data. Nonparametric analyses examined differences in the two ratios across age and education groups. Two-step cluster analyses were conducted to identify potential subgroups. Across the entire sample, the verb-noun ratio (mean&#x2009;=&#x2009;0.13) and adjective-noun ratio (mean&#x2009;=&#x2009;0.12) were substantially lower than the ratios derived from corpus data (0.46 and 0.35 respectively, ps&#x2009;&#x2264;&#x2009;.001). Age, education, and total number of words produced were significantly associated with both ratios but with small to medium effect sizes and large variability. Cluster analyses identified three subgroups for the verb-noun ratio but yielded two highly unequal subgroups for the adjective-noun ratio. The two ratios derived from fluency tasks are not directly comparable to those derived from corpora. The small-to-medium effect sizes of the variables studied and the subgroup patterns observed for the verb-noun ratio suggest that additional, as yet unexplored, factors contribute to grammatical category production in phonemic fluency. This study provides novel quantitative data regarding content word distributions in phonemic fluency and their demographic correlates. Future research should examine the potential clinical relevance of these ratios.

Adults with Tourette syndrome (TS) are more prone to depression and comorbid anxiety disorders than neurotypical individuals. Conflicting findings regarding their cognitive performance may stem from various factors, including comorbidities. Our primary goal is to assess patients' inhibition to interference, motor dexterity, nonverbal memory, and visuospatial functions, and to examine the impact of concomitant anxious-depressive symptoms that often accompany TS. It is hypothesized that individuals with TS who also have anxiety and depression symptoms will demonstrate significantly altered inhibition, motor dexterity, and visuospatial skills compared to both the neurotypical and non-comorbid clinical groups. We also propose identifying neuropsychological variables that best discriminate between comorbid and non-comorbid groups, as well as between these groups and neurotypical controls. We compared the neuropsychological profile of 128 participants divided into three groups: a TS+ clinical group with anxiety and depression comorbidities (n&#x2009;=&#x2009;21), a TS- clinical group without significant comorbidity (n&#x2009;=&#x2009;37), and a neurotypical control group (n&#x2009;=&#x2009;70). Neuropsychological assessments included the Stroop Color-Word Test (inhibition), the Purdue pegboard (motor dexterity), and Rey-Osterrieth Complex Figures (visuospatial functions and nonverbal memory). No significant group differences emerged in interference inhibition. Both TS- and TS+ participants outperformed controls in fine motor dexterity tasks. However, only the TS+ group showed impairments in visuospatial functions and nonverbal memory. These results suggest that anxiety and depressive comorbidity in individuals with TS may specifically alter nonverbal memory and visuospatial functions.

Measurement bias - systematic errors that lead to inaccuracies in assessing latent constructs - threatens to invalidate analysis and interpretation of ourcome scores collected in the context of clinical trials, longtiudinal research, and other types of neurocognitive studies; however, there has been little effort to examine this issue in tasks recommended by the National Institute of Health's Research Domain Criteria (RDoC) for neuropsychological research. We aimed to evaluate measurement bias for sex, age, years of education, educational discouragement, underrepresented racial/ethnic identity, and household income in seven RDoC-recommended tasks. We recruited a sample of 320 individuals balanced for race, age, sex, and income. All participants completed a demographic survey and battery of neurocognitive tasks. We used Multiple Indicators Multiple Causes models to assess bias related to these factors. Evidence of negative bias associated with older age was found for the Continuous Performance Task (CPT), and evidence of positive bias with older age was found for the Flanker task. Evidence of positive bias associated with sex, favoring women, was found for the Self-Ordered Pointing Task (SOPT). Additionally, evidence of negative bias associated with years of education was found for the CPT. No evidence of bias was found for the Sternberg task, Probabilistic Learning Task, or Effort-Expenditure for Rewards Task (EEfRT). Overall, we did not find evidence of bias related to income, race, or educational discouragement. Certain tasks in this battery may be biased due to age, sex, and education, suggesting that researchers should be cautious when using these particular tasks as part of a battery in neuropsychological research with diverse populations.

Adolescence is a developmental period where executive functions differentiate and mature. Prior research suggests that transdiagnostic processes - i.e. mechanisms that serve as risk or maintaining factors of psychopathology - negatively impact adolescent executive functioning both concurrently and over time. Understanding how these processes and executive functioning are assessed and interrelated can help neuropsychologists make more accurate diagnostic and treatment recommendations. This study aimed to identify concurrent and longitudinal correlates between adolescent executive functioning and transdiagnostic processes, including emotion regulation, affect, and Hierarchical Taxonomy of Psychopathology (HiTOP) spectra (i.e. higher-order symptom domains like internalizing, externalizing, and somatic symptoms), using a multi-informant, multi-method design. We assessed 100 adolescents using behavioral, self- and parent-reported measures of these transdiagnostic processes and executive functioning across two time points. Effect sizes of unadjusted, bivariate correlations were examined. Performance-based executive functioning did not correlate with self- or informant-reported executive functioning. Cross-informant agreement, however, was often evident for executive function tasks at small effects. While patterns of correlations generally differed across the assessment approaches and informants, negative affect and externalizing symptoms consistently showed small associations with concurrent executive functioning. Affective demands (e.g. emotion regulation difficulties, internalizing symptoms, negative affect) were negatively associated with concurrent executive functioning, suggesting that such burdens may compromise adolescents' performance on executive tasks. Clinicians are encouraged to evaluate internalizing symptoms contemporaneously with executive function testing, and to attend carefully to adolescent - informant relationships and disclosure dynamics. Implications for multi-method, multi-informant approaches to adolescent assessment are discussed.

Training models in clinical neuropsychology have followed the Houston Conference Guidelines for decades. Those Guidelines provided strong emphasis on research training as a core competency for neuropsychologists. The new Minnesota Conference Guidelines (in final stages of development as of this essay) mention that training in the conduct of research is part of the graduate education of neuropsychologists. All four of the current authors were trained in the Iowa-Benton approach to neuropsychology, which is firmly grounded in research training and engagement. We view this not as a prerogative, but as a requirement. Training in clinical neuropsychology should not be "clinical" with a twist of "research" - it should be a healthy admixture of both. Our research training made us better clinical neuropsychologists, and provides a foundation for our teaching, exactly in the spirit that Arthur Benton promoted in his mentoring model. Further, our research experience informs our appraisal and adoption of contemporary trends in the practice of neuropsychology, and proposed new procedures and tests in the Benton Clinic are evaluated through the lens of background research.