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Introduction: The impact of cognitive functions on treatment outcomes in forensic psychiatric patients with substance use disorders is not well understood. This study investigates whether neuropsychological deficits, such as in attention, executive functions, and social-emotional cognition, are associated with impulsivity and criminal history. Methods: 109 male patients with substance use disorders at the Clinic for Forensic Psychiatry in Rostock were screened using inclusion and exclusion criteria, with 30 consenting to participate. The tests included the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive functions in the areas of attention, psychomotor speed, social and emotional perception, and executive functions, with a particular focus on decision making, planning and problem solving. The Barratt Impulsiveness Scale (BIS-11) was used to measure impulsiveness. Results: Participants displayed significantly higher impulsivity levels on the BIS-11 compared to the general population and showed marked deficits in attention, psychomotor speed, and executive functions. There was a minimal correlation between impulsivity and cognitive performance, suggesting that impulsivity does not directly predict cognitive impairments. Notably, extensive criminal histories correlated with poorer cognitive performance, particularly in tasks requiring planning and problem-solving. Discussion: We found mixed support for the hypothesized associations between neuropsychological functions and criminal histories among patients with substance use disorders. While tasks related to planning and sustained attention showed clearer links, broader cognitive functions displayed inconsistent correlations. These findings emphasize the complexity of the relationship between cognitive deficits, impulsivity, and criminal history, highlighting the necessity for tailored assessments and rehabilitation strategies to enhance outcomes. Future research should focus on larger, longitudinal studies to validate these findings and refine therapeutic approaches.
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BACKGROUND: The high number and clinical heterogeneity of neurological impairments in patients with a post-COVID-19 condition (PCC) poses a challenge for outpatient care. OBJECTIVE: Our aim was to evaluate the applicability of the proposed subtypes according to the guidelines "Long/Post-COVID" (30 May 2024) and their phenotyping using clinical and neuropsychological findings from our post-COVID outpatient clinic. METHODS: The evaluation was based on cross-sectional neurological and psychological test examinations of the patients, which were carried out using standardized questionnaires and test batteries. In addition, a detailed anamnesis of the current symptoms and a retrospective survey of the acute symptoms up to 4 weeks after the confirmed infection was conducted. The subtypes were classified according to the abovementioned guidelines based on the medical history and selected patient questionnaires, to which we added a 5th subtype with reference to the previous guidelines "Long/Post-COVID" (as of 5 March 2023). RESULTS: A total of 157 patients were included between August 2020 and March 2022. The presentation was at a median of 9.4 months (interquartile range, IQRâ¯= 5.3) after infection, with a mean age of 49.9 years (IQRâ¯= 17.2) and more women (68%) presenting, with a total hospitalization rate of 26%. Subtype 1 (postintensive care syndrome) showed the highest proportion of men, highest body mass index (BMI) scores and the highest rates of subjective complaints of word-finding difficulties (70%). Subtype 2 (secondary diseases) was dominated by cognitive impairment and had the highest depression scores. Subtype 3 (fatigue and exercise-induced insufficiency) was the most common, had the most symptoms and most severe subjective fatigue and the largest proportion of women. Subtype 4 (exacerbation) mainly showed affective symptoms. Subtype 5 (complaints without relevance to everyday life) had the lowest scores for depression, fatigue and BMI. Neurological and psychological conditions were frequently pre-existing in all groups. DISCUSSION: The management of PCC can be improved at various levels. A standardized subtype classification enables early individually tailored treatment concepts. Patients at risk should be identified at the primary care level and informed about risk factors and prevention strategies. Regular monitoring of cardiovascular risk factors and physical activity are essential for PCC treatment. In the case of cognitive deficits and concurrent affective symptoms, psychotherapeutic support and drug treatment with selective serotonin reuptake inhibitors (SSRI) should be provided at an early stage.
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Background: The WHO estimates that close to 1.7 billion people worldwide have hearing loss; 34 million of whom are children, with 90% residing in low- and middle-income countries. While the effects of ear disease and hearing loss on language, academic, and behavioral development are established, there is remarkably little data on intellectual and other cognitive differences. Methods: Here we report results from an extension of a randomized controlled vaccination trial originally carried out between 2000 and 2004. Primary caregivers completed demographic and household questionnaires. Beginning in 2016, children were followed up for a hearing and ear disease evaluation. Participants also completed extensive cognitive testing, which included the domains of IQ, language, attention and processing speed, visual and visuospatial skills, and learning and memory. The association between ear disease and hearing loss and each of the cognitive outcomes was examined using multivariate linear regression models. Findings: We followed up 8926 children ages 14-19 years old. Children with hearing loss or ear disease had lower socioeconomic status compared to children without. However, even after controlling for a high number of covariates, all levels of ear disease or hearing loss were associated with clinically relevant reductions across all cognitive domains, though effect sizes were small. Even mild ear disease or hearing loss was associated with a -0.15 (95% CI: -0.20, -0.11) and a -0.23 (95% CI: -0.32, -0.14) standard deviation reduction, respectively, in IQ. The effects of ear disease and hearing loss were additive as children with both had the lowest cognitive scores. Interpretation: Untreated ear disease and hearing loss exert measurable effects on cognition that are able to be detected into the teenage years. Early identification of hearing loss and chronic ear disease may have lifelong benefits. Individuals with ear disease and/or hearing loss may require supports and services in addition to those related to speech and language therapy. Funding: The Bill and Melinda Gates Foundation OPP1142570.
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HIV stigma is associated with suboptimal clinical outcomes and has been cross-sectionally linked to cognitive deficits in people with HIV (PWH). However, it is unclear whether HIV stigma precedes cognitive decline or vice versa. We examined associations in 303 adult PWH (mean age 50.01 (11.91) years; 46% female; 67% non-Hispanic Black) between the abbreviated Berger Stigma Scale score and longitudinal change across the NIH Toolbox Cognition Battery measures. 89% of participants reported experiencing HIV stigma. In unadjusted analyses, greater HIV stigma was associated with worse attention performance at yearly follow-up visits (B = -0.07, 95% CI = -0.13 - -0.01, p = 0.025). When adjusting for clinicodemographic variables, HIV stigma was associated with worse processing speed and global cognition at yearly follow-up visits. This finding suggests that HIV stigma precedes subsequent cognitive decline and highlights the importance of reducing stigma to improve cognitive functioning among PWH.
RESUMEN: El estigma del VIH está asociado con resultados clínicos subóptimos y se ha vinculado transversalmente con déficits cognitivos en personas con VIH (PCV). Sin embargo, no está claro si el estigma del VIH precede al deterioro cognitivo o viceversa. Examinamos las asociaciones en 303 adultos con VIH (edad media de 50.01 (11.91) años; 46% mujeres; 67% negros no hispanos) entre la escala abreviada de Estigma de Berger y el cambio longitudinal a través de las medidas de la Batería de Cognición de el NIH Toolbox. El ochenta y nueve por ciento de los participantes reportaron haberse sentido estigmatizados en relacionado con el VIH. En análisis no ajustados, un mayor estigma del VIH se asoció con un peor desempeño en atención en las visitas anuales (B = -0.07, IC del 95% = -0.13 -0.01, p = 0.025). Al ajustar por variables clínico-demográficas, el estigma del VIH se asoció con una peor velocidad de procesamiento y cognición global en las visitas anuales. Este resultado sugiere que el estigma del VIH precede al deterioro cognitivo subsiguiente y resalta la importancia de reducir el estigma para mejorar la función cognitiva entre las PCV.
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BACKGROUND AND PURPOSE: Early diagnosis and the refinement of treatment of patients with intracranial meningiomas have brought quality of life (QoL) and neurocognitive functioning as outcome measures into focus. The aim of this study is a comprehensive assessment of neurocognitive function, quality of life and the presence of depression in meningioma patients before and after surgery. METHODS: Patients with MRI diagnosis of intracranial meningioma and indication for surgery were prospectively included. A clinical neuropsychologist performed neurocognitive assessments within 3 months before and 12 months after surgery. The test battery included investigation of selective and divided attention, verbal and figural memory, executive functioning, and word fluency. Self-report questionnaires to assess depressive symptoms, QoL, and disease coping were administered. Raw values and t-values were compared pre-and postoperatively. Outcome was stratified by tumor- and peritumoral brain edema (PTBE) volumes, postoperative resolution of PTBE and WHO grade. The study included 18 predominantly female patients (83%) with a median age of 59 years and mostly CNS WHO grade 1 meningiomas (83%). RESULTS: There was a significant postoperative improvement in the ability to selectively react under stress, in working memory and improved delayed reproduction of verbal and visual memory content. QoL improved regarding a reduction in physical problems, an improvement in energy, and social functioning. There was a trend towards worse preoperative scores in all tests, and greater postoperative improvement in patients with PTBE. Tumor volume had no effect on the measured outcome. The patients did not suffer from depressive symptoms before the surgery but improved postoperatively and most patients had an active, problem-oriented coping strategy. CONCLUSION: Resection of intracranial meningiomas leads to an improvement in multiple neurocognitive domains and QoL. There is a trend towards poorer preoperative neurocognitive functioning and greater postoperative improvement in patients with PTBE. Depression appears to play a minor role in the context of neurocognitive functioning and disease coping.
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Neoplasias Meníngeas , Meningioma , Testes Neuropsicológicos , Qualidade de Vida , Humanos , Meningioma/cirurgia , Meningioma/psicologia , Meningioma/complicações , Feminino , Masculino , Qualidade de Vida/psicologia , Pessoa de Meia-Idade , Neoplasias Meníngeas/cirurgia , Neoplasias Meníngeas/psicologia , Neoplasias Meníngeas/complicações , Estudos Prospectivos , Idoso , Adulto , Depressão/psicologia , Depressão/etiologia , Resultado do Tratamento , Procedimentos Neurocirúrgicos/métodos , Cognição/fisiologiaRESUMO
Introduction: Electroconvulsive therapy (ECT) is the most effective treatment for patients suffering from treatment-resistant depression but its use is often limited by the concern for cognitive side effects. This study examines the effect of ECT on autobiographical and verbal memory compared to a healthy control group and the impact of the mean stimulus dose on cognition after ECT. Methods: Autobiographical and verbal memory were assessed in depressed patients and healthy controls before the first and within one week after the last ECT treatment. Neuropsychological testing included the Autobiographical Memory Interview, the Verbal Learning and Memory Test and five tests from the Cambridge Neuropsychological Test Automated Battery. The mean charge delivered across the ECT series and the total number of sessions were examined in relationship to cognitive impairment after ECT using a multiple regression model. Results: Autobiographical memory was significantly impaired after ECT treatment compared to healthy controls. Baseline scores were lower for depressed patients on all cognitive domains. Improvements in performance after ECT were found on tests for executive functions and working memory. Effects of the mean charge delivered on cognitive functioning after ECT were heterogeneous across cognitive domains but significant for verbal retrograde memory. Conclusion: ECT led to autobiographical memory impairment. The relationship between mean charge delivered and cognitive performance is heterogeneous across different cognitive domains and requires further research. Significant effects of the mean charge delivered were found without a significant difference in cognitive functioning compared to a healthy control group.
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OBJECTIVE: People with bipolar disorder (BD) often show inaccurate subjective ratings of their objective cognitive function. However, it is unclear what information individuals use to formulate their subjective ratings. This study evaluated whether people with BD are likely using information about their crystallized cognitive abilities (which involve an accumulated store of verbal knowledge and skills and are typically preserved in BD) or their fluid cognitive abilities (which involve the capacity for new learning and information processing in novel situations and are typically impaired in BD) to formulate their subjective cognitive ratings. METHOD: Eighty participants diagnosed with BD and 55 control volunteers were administered cognitive tests assessing crystallized and fluid cognitive abilities. Subjective cognitive functioning was assessed with the Cognitive Failures Questionnaire (CFQ), daily functioning was rated using the Multidimensional Scale of Independent Functioning (MSIF) and the Global Assessment of Functioning Scale (GAF), and quality of life was assessed with the Quality of Life in Bipolar Disorder scale (QoL.BD). RESULTS: The BD group exhibited considerably elevated subjective cognitive complaints relative to controls. Among participants with BD, CFQ scores were associated with fluid cognitive abilities including measures of memory and executive function, but not to crystallized abilities. After controlling for objective cognition and depression, higher cognitive complaints predicted poorer psychosocial outcomes. CONCLUSIONS: Cognitive self-reports in BD may represent a metacognitive difficulty whereby cognitive self-appraisals are distorted by a person's focus on their cognitive weaknesses rather than strengths. Moreover, negative cognitive self-assessments are associated with poorer daily functioning and diminished quality of life.
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Accelerated long-term forgetting (ALF) is the phenomenon whereby material is retained normally over short intervals (e.g. minutes) but forgotten abnormally rapidly over longer periods (days or weeks). ALF may be an early marker of cognitive decline, but little is known about its relationships with preclinical Alzheimer's disease pathology, and how memory selectivity may influence which material is forgotten. We assessed ALF in 'Insight 46', a sub-study of the MRC National Survey of Health and Development (a population-based cohort born during one week in 1946) (n=429; 47% female; assessed aged â¼73 years). ALF assessment comprised visual and verbal memory tests: Complex Figure Drawing and the Face-Name Associative Memory Exam (FNAME). ALF scores were calculated as the percentage of material retained after 7 days, relative to 30 minutes. In 306 cognitively-normal participants, we investigated effects on ALF of ß-amyloid pathology (quantified using 18F-Florbetapir-PET, classified as positive/negative) and whole-brain and hippocampal atrophy rate (quantified from serial T1-MRI over â¼2.4 years preceding the ALF assessment), as well as interactions between these pathologies. We categorized Complex Figure Drawing items as 'outline' or 'detail', to test our hypothesis that forgetting the outline of the structure would be more sensitive to the effect of brain pathologies. We also investigated associations between ALF and Subjective Cognitive Decline, measured with the MyCog questionnaire. Complex Figure 'outline' items were better retained than 'detail' items (mean retention over 7 days = 94% vs 72%). Amyloid-positive participants showed greater forgetting of the Complex Figure outline, compared to amyloid-negatives (90% vs 95%; P<0.01). There were interactions between amyloid pathology and cerebral atrophy, such that whole-brain and hippocampal atrophy predicted greater ALF on Complex Figure Drawing among amyloid-positives only (e.g. 1.9 percentage-points lower retention per ml/year of whole-brain atrophy [95% confidence intervals 0.5, 3.7]; P<0.05). Greater ALF on FNAME was associated with increased rate of hippocampal atrophy. ALF on Complex Figure Drawing also correlated with subjective cognitive decline (-0.45 percentage-points per MyCog point [-0.85, -0.05], P<0.05). These results provide evidence of associations between some measures of ALF and biomarkers of brain pathologies and subjective cognitive decline in cognitively-normal older adults. On Complex Figure Drawing, 'outline' items were better remembered than 'detail' items - illustrating the strategic role of memory selectivity - but 'outline' items were also relatively more vulnerable to ALF in individuals with amyloid pathology. Overall, our findings suggest that ALF may be a sensitive marker of cognitive changes in preclinical Alzheimer's disease.
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BACKGROUND: This study aimed at assessing the clinical utility of the Verbal Fluency Index (VFI) over a classical phonemic verbal fluency test in Italian-speaking amyotrophic lateral sclerosis (ALS) patients. METHODS: N = 343 non-demented ALS patients and N = 226 healthy controls (HCs) were administered the Verbal fluency - S task from the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). The associations between the number of words produced (NoW), the time to read words aloud (TRW) and the VFI (computed as [(60"-TRW)/NoW]) on one hand and both bulbar/respiratory scores from the ALS Functional Rating Scale - Revised (ALSFRS-R) and the ECAS-Executive on the other were tested. Italian norms for the NoW and the VFI were derived in HCs via the Equivalent Score method. Patients were classified based on their impaired/unimpaired performances on the NoW and the VFI (NoW-VFI-; NoW-VFI+; NoW + VFI-; NoW + VFI+), with these groups being compared on ECAS-Executive scores. RESULTS: The VFI, but neither the NoW nor the TRW, were related to ALSFRS-Bulbar/-Respiratory scores; VFI and NoW measures, but not the TRW, were related to the ECAS-Executive (p < .001). The NoW slightly overestimated the number of executively impaired patients when compared to the VFI (31.1% vs. 26.8%, respectively). Patients with a defective VFI score - regardless of whether they presented or not with a below-cutoff NoW - reported worse ECAS-Executive scores than NoW + VFI + ones. CONCLUSIONS: The present reports support the use of the Italian VFI as a mean to validly assess ALS patients' executive status by limiting the effect of motor disabilities that might undermine their speech rate.
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The best predictor of functional outcome in victims of traumatic brain injury (TBI) is a neuropsychological evaluation. An exponential growth of research into TBI has focused on diagnosis and treatment. Extant literature lacks a comprehensive neuropsychological review that is simultaneously scholarly and practical. In response, our group included, and went beyond a general overview of TBI's, which commonly include definition, types, severity, and pathophysiology. We incorporate reasons behind the use of particular neuroimaging techniques, as well as the most recent findings on common neuropsychological assessments conducted in TBI cases, and their relationship to outcome. In addition, we include tables outlining estimated recovery trajectories of different age groups, their risk factors and we encompass phenomenological studies, further covering the range of existing-promising tools for cognitive rehabilitation/remediation purposes. Finally, we highlight gaps in current research and directions that would be beneficial to pursue.
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BACKGROUND: While numerous studies have indicated acute neurocognitive changes following the administration of Δ9-tetrahydrocannabinol (THC; the psychoactive component of cannabis), the standardised neuropsychological tests most sensitive to THC are yet to be identified. As such, this systematic review analysed scientific evidence (since 2000) on the effects of THC on standardised neuropsychological test measures. METHODS: This review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were eligible for inclusion if they utilised a between or within-subjects design in testing for differences in standardised neuropsychological test performance following the consumption of THC. RESULTS/DISCUSSION: Sufficient data were identified to examine 8 standardised neuropsychological test measures, with 12 studies being eligible for inclusion in the review. It was identified that the Cambridge Neuropsychological Test Automated Battery (CANTAB) subtest Spatial Working Memory, Hopkins Verbal Learning Test, Prose Recall and Rey Auditory Verbal Learning Test were sensitive to cannabis consumption. LIMITATIONS: However, due to substantial variability observed across studies, the data could not be quantitatively analysed. It was noted that few studies employed standardised neuropsychological measures in assessing the effects of THC. CONCLUSION: Overall, the findings highlight the need for further research examining the effects of cannabis on standardised and validated measures of neurocognitive function. Such an approach can be considered an important first step towards developing behavioural measures of impairment.
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This viewpoint explores the gap between theoretical frameworks in experimental neuroscience and clinical neuropsychology. It highlights how John Duncan's theory of the Multiple Demand (MD) system, which links the frontal lobe to fluid intelligence (g), helps explain general performance on classical executive tests. However, it also discusses how traditional scores often fail to capture the complexity of behaviours associated with frontal lobe damage, and we suggest that developing improved scoring methods could be useful for integrating experimental and clinical neuropsychology insights.
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OBJECTIVE: To introduce New2Neuropsychology (N2N), an organization that seeks to increase recruitment of historically underrepresented minoritized (URM) students, and to examine preliminary data on N2N's impact and effectiveness in increasing knowledge about neuropsychology for URM students. METHOD: This paper reviews relevant literature on factors informing the development of N2N. We also present descriptive data on N2N's impact to date, and results of pre- and post- surveys for presentations about neuropsychology delivered to 90 college students (mean age = 24.23, 64.4% juniors or seniors) between November 2021 - March 2023. RESULTS: N2N has reached >500 students in events across 27 schools and, with the American Academy of Clinical Neuropsychology, disseminated $84,000 in scholarships to URM students. N2N presentation attendees reported increased understanding of neuropsychology and the training pathway (ps < .001, Cohen's ds = 0.94 - 1.73) and increased confidence in their ability to become neuropsychologists (p < .001, d = 0.41). There were no overall pre-post differences for interest in pursuing a career in neuropsychology (p > .05); however, a subset of students who reported low interest at baseline (n = 57) reported a statistically significant increase in their interest post-presentation (p < .01, d = 0.36). CONCLUSIONS: To date, N2N has progressed toward its goal, showing preliminary success increasing knowledge about neuropsychology for URM students. With continued development and support, N2N seeks to transform the pathway to neuropsychology for URM students, expanding accessibility of N2N resources across diverse groups and connecting URM students to neuropsychology research and clinical experiences.
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OBJECTIVE: Neuropsychological assessment through VideoTeleConferencing (VTC) can help improve access to diagnostic and follow-up care in memory clinics. This study investigated the stability of performance on VTC assessment in relation to in-person assessment using a test-retest design and explored user experiences of VTC assessment. MATERIALS AND METHODS: Thirty-one patients (62 ± 6.7 years, 45% female, 58% Subjective Cognitive Decline, 42% Mild Cognitive Impairment/dementia diagnosis) were included from the Amsterdam Dementia Cohort between August 2020 and February 2021. Patients underwent a face-to-face neuropsychological assessment followed by a VTC assessment using the same test protocol within 4 months. Reliability coefficients were calculated using intraclass correlation coefficients (ICC). For each test, the proportion of clinically relevant differences in performances between assessment modalities was calculated. User experiences of patients and neuropsychologists were assessed with questionnaires (User Satisfaction and Ease of use [USE] questionnaire and System Usability Scale [SUS]). Neuropsychologists also participated in a focus group. RESULTS: ICC values were moderate to excellent (0.63-0.93) for all test measures in the total sample. On all tests, most patients did not show clinically relevant performance differences between modalities. Patients and neuropsychologists reported overall positive VTC system usability, although neuropsychologists indicated in the focus group that patients without cognitive impairment required less training for the system and were more independent. CONCLUSION: VTC assessment showed adequate to excellent test-retest reliability for a broad range of neuropsychological tests commonly used in practice. Assessment through VTC may be a user friendly method in the memory clinic, especially to monitor individuals at risk for future cognitive decline.
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OBJECTIVE: Neuropsychological assessment of preschool children is essential for early detection of delays and referral for intervention prior to school entry. This is especially pertinent in low- and middle-income countries (LMICs), which are disproportionately impacted by micronutrient deficiencies and teratogenic exposures. The Grenada Learning and Memory Scale (GLAMS) was created for use in limited resource settings and includes a shopping list and face-name association test. Here, we present psychometric and normative data for the GLAMS in a Grenadian preschool sample. METHODS: Typically developing children between 36 and 72 months of age, primarily English speaking, were recruited from public preschools in Grenada. Trained Early Childhood Assessors administered the GLAMS and NEPSY-II in schools, homes, and clinics. GLAMS score distributions, reliability, and convergent/divergent validity against NEPSY-II were evaluated. RESULTS: The sample consisted of 400 children (190 males, 210 females). GLAMS internal consistency, inter-rater agreement, and test-retest reliability were acceptable. Principal components analysis revealed two latent factors, aligned with expected verbal/visual memory constructs. A female advantage was observed in verbal memory. Moderate age effects were observed on list learning/recall and small age effects on face-name learning/recall. All GLAMS subtests were correlated with NEPSY-II Sentence Repetition, supporting convergent validity with a measure of verbal working memory. CONCLUSIONS: The GLAMS is a psychometrically sound measure of learning and memory in Grenadian preschool children. Further adaptation and scale-up to global LMICs are recommended.
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Objectives: We aimed to advance our understanding of the effect of chess on cognition by expanding previous univariate studies with the use of graph theory on cognitive data. Specifically, we investigated the cognitive connectome of adult chess players. Method: We included 19 chess players and 19 controls with ages between 39 and 69 years. Univariate analysis and graph theory included 27 cognitive measures representing multiple cognitive domains and subdomains. Graph analysis included global and nodal measures of integration, segregation, and centrality. We also performed an analysis of community structures to gain an additional understanding of the cognitive architecture of chess players. Results: The analysis of global graph measures showed that chess players had a higher local efficiency than controls at the cost of a lower global efficiency, which did not permeate segregation aspects of their connectome. The nodal graph measures showed that executive/attention/processing speed and visuoconstructive nodes had a central role in the connectome of chess players. The analysis of communities showed that chess players had a slightly reorganized cognitive architecture into three modules. These graph theory findings were in the context of better cognitive performance in chess players than controls in visuospatial abilities. Conclusion: We conclude that the cognitive architecture of chess players is slightly reorganized into functionally and anatomically coherent modules reflecting a distinction between visual, verbal, and executive/attention/processing speed-related functions, perhaps reminiscent of right hemisphere and left hemisphere subnetworks orchestrated by the frontal lobe and its white matter connections.
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Introduction: Normative cognitive data can distinguish impairment from healthy cognitive function and pathological decline from normal ageing. Traditional methods for deriving normative data typically require extremely large samples of healthy participants, stratifying test variation by pre-specified age groups and key demographic features (age, sex, education). Linear regression approaches can provide normative data from more sparsely sampled datasets, but non-normal distributions of many cognitive test results may lead to violation of model assumptions, limiting generalisability. Method: The current study proposes a novel Bayesian framework for normative data generation. Participants (n = 728; 368 male and 360 female, age 18-75 years), completed the Cambridge Neuropsychological Test Automated Battery via the research crowdsourcing website Prolific.ac. Participants completed tests of visuospatial recognition memory (Spatial Working Memory test), visual episodic memory (Paired Associate Learning test) and sustained attention (Rapid Visual Information Processing test). Test outcomes were modelled as a function of age using Bayesian Generalised Linear Models, which were able to derive posterior distributions of the authentic data, drawing from a wide family of distributions. Markov Chain Monte Carlo algorithms generated a large synthetic dataset from posterior distributions for each outcome measure, capturing normative distributions of cognition as a function of age, sex and education. Results: Comparison with stratified and linear regression methods showed converging results, with the Bayesian approach producing similar age, sex and education trends in the data, and similar categorisation of individual performance levels. Conclusion: This study documents a novel, reproducible and robust method for describing normative cognitive performance with ageing using a large dataset.
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Objective: While previous survey research has focused on various training constituencies such as trainees, and postdoctoral/internship supervisors, no previous survey research has examined the needs and perspectives of practicum level supervisors and training programs. This study was designed to address this limitation. These results were used in forming the North American Association of Practicum Sites in Neuropsychology (NAPSN). Method: A 41-item survey was developed and distributed to practicum supervisors across the United States and Canada via listserv. A total of 142 supervisors completed the survey; the majority were employed at academic medical centers (62%) and located in the U.S. (93%). Most participants evaluated adults (61%), while a minority evaluated children (27%), or patients across the lifespan (12%). Results: Most respondents supervise one (44%) or two (26%) students per year and prefer advanced trainees (>90%). The majority (78%) indicated students see one case per week. The number of clinical contact hours and reports varied based on location (U.S. vs. Canada) and population (adult vs. pediatric). Supervisors found professional papers and publicly available didactics to be the most helpful resources. Commonly endorsed needs included help with policies and procedures (53%), supervising trainees from underrepresented groups (49%) and nontraditional backgrounds (44%), and access to didactics (49%). Conclusions: The survey provided insights into current practices and the needs of practicum supervisors. These findings will inform NAPSN's development of materials and policies to support trainees and supervisors and can guide other professionals in supporting their practicum trainees as they navigate training in neuropsychology.