Archives Of Clinical Neuropsychology[JOURNAL]
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200 papers
Laying the Groundwork for Clinical Neuropsychology in Romania: Beliefs and Practices of Psychologists Regarding Validity Testing in Clinical Assessment.
Šakotić RJ, Crişan I
Arch Clin Neuropsychol · 2026 Feb · PMID 41396654 · Publisher ↗
OBJECTIVE: The present study aimed to explore and document Romanian psychologists' practices and beliefs regarding validity testing in clinical assessment, given the lack of neuropsychology as a practice field in this co...
OBJECTIVE: The present study aimed to explore and document Romanian psychologists' practices and beliefs regarding validity testing in clinical assessment, given the lack of neuropsychology as a practice field in this country. METHOD: We developed a questionnaire addressing several key aspects, including demographic and professional information, and beliefs and practices related to validity testing in clinical assessment. The questionnaire was distributed to all practitioners licensed in clinical psychology registered on the official website of the Romanian College of Psychologists (RCP). The final sample consisted of 344 practitioners, 312 of whom had been active in assessments during the previous year. RESULTS: Our findings revealed several cultural particularities, including the preference of 49.4% of the sample for employing the Tree Drawing Test (Koch, K. (1954). Der Baumtest - Der Baumzeichenversuch als psychodiagnostisches Hilfsmittel. Hans Huber. Romanian translation by Mocanu, S. (2002). Testul Arborelui - Diagnosticul psihologic cu ajutorul testului arborelui. Profex. Bucuresti) - a projective drawing technique - as a validity test. Only 16.7% of practitioners reported using empirically supported validity tests in clinical evaluations, and several performance validity tests were reported by 2-12.5% of the sample. Additionally, the prevalence of malingering was estimated to be 5%-20% and most respondents associated it with personality disorders. CONCLUSIONS: The results indicate a need to bridge the gap between science and practice by adopting evidence-based approaches within the Romanian assessment culture. Our survey offers novel empirical insights into the current state of validity assessment in Romania, thereby contributing foundational knowledge that may support the legitimization and further development of neuropsychology within the national context.
The Role of Dyads in Subjective Reporting and Prediction of Cognitive Worsening in Cognitively Unimpaired Individuals and Individuals with Subjective Cognitive Decline: Results of the CompAS Longitudinal Study.
Pérez-Blanco L, Nieto-Vieites A, Felpete-López A … +5 more , Mallo SC, Arora S, Lojo-Seoane C, Juncos-Rabadán O, Pereiro AX
Arch Clin Neuropsychol · 2026 Feb · PMID 41396651 · Full text
OBJECTIVE: The main aim was to examine the value of agreement on subjective cognitive complaints (SCCs) reported by study participants and informants in predicting worsening cognitive function over time in cognitively un...
OBJECTIVE: The main aim was to examine the value of agreement on subjective cognitive complaints (SCCs) reported by study participants and informants in predicting worsening cognitive function over time in cognitively unimpaired (CU) and subjective cognitive decline (SCD) participants. METHODS: The sample consisted of 175 participants from the CompAS study (CU = 139; SCD = 36), who were followed up three times along a period from 17 to 76 months after the start of the study. Levels of agreement on the "Dyadic SCCs" were categorized according to whether informant and participant scores at baseline on the short version of the "Questionnaire d'Autoevaluation de la Memoire" were above or below a cut-off point accounting for age-related normative complaints. Two categories of agreement were identified: (a) participant scores above the cut-off and informant scores below the cut-off ("Self-over-reporting"); (b) both participant and informant scores above the cut-off point ("Agreement on presence"). We performed Cox proportional hazards regression model adjusted for sex, age, and years of education. RESULTS: The tested model yielded statistical significant findings and acceptable model fit parameters. "Dyadic SCCs" significantly predicted cognitive worsening over time, with "Self-over-reporting" acting as a better indicator of the risk than "Agreement on presence" in both CU and SCD groups. CONCLUSIONS: The data showed that the "Self-overreporting," compared to "Agreement on presence," increases the risk of worsening per time unit. The findings may be explained by greater awareness of one's own difficulties (hypernosognosia) in preclinical stages of cognitive decline.
Correction to: Performance on the Hayling and Brixton tests in older adults: Norms and correlates.
Arch Clin Neuropsychol · 2026 Feb · PMID 41388956 · Full text
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Concussion in the Wild: Clinical Utility of Ambulatory Assessment of Symptoms and Everyday Exposures in Adolescents and Adults with Concussion.
Durfee KJ, Elbin RJ, Womble MN … +5 more , Jennings S, Dollar CM, Schatz P, Elbich DB, Hakun JG
Arch Clin Neuropsychol · 2026 Feb · PMID 41370212 · Publisher ↗
OBJECTIVE: To describe the degree of correspondence between ecological momentary assessment (EMA) symptom ratings and cognitive performance derived from the Mobile Neurocognitive Health Project (MNCH) and clinic-based st...
OBJECTIVE: To describe the degree of correspondence between ecological momentary assessment (EMA) symptom ratings and cognitive performance derived from the Mobile Neurocognitive Health Project (MNCH) and clinic-based standard-of-care assessments in adolescents and adults with concussion. Environmental exposures, avoidance behavior, and symptom reactivity data were documented, and the clinical utility of the MNCH protocol for predicting protracted recovery was examined. METHOD: 89 patients (13-25 yrs) with concussion enrolled in the MNCH study on their smartphones within one week of injury. Participants completed four brief surveys per day for a 7-day period. The surveys included assessments of environmental exposures, avoidance of symptom-provoking environments, symptom ratings, ultra-brief performance-based cognitive assessments, and ratings of symptom reactivity to the surveys and cognitive assessments. The primary criteria used for determining the utility of EMA-based data were the degree of correspondence with in-clinic symptom ratings and cognitive performance, and the ability of EMA-based measures to predict risk for protracted recovery. RESULTS: Symptom scores and cognitive performance outcomes obtained via EMA were significantly associated with in-clinic symptom ratings (PCSS) and computerized neurocognitive testing (ImPACT). Multiple logistic modeling results indicated that EMA total symptom scores were stronger predictors of protracted recovery than in-clinic symptom ratings. Additionally, ratings of avoidance behavior and reactivity to the EMA surveys and assessments were significantly associated with protracted recovery. CONCLUSIONS: Valid estimates of concussion symptoms may be obtained via remote, unsupervised, high-frequency assessment. In addition to EMA-based symptom scores, avoidance behavior and symptom reactivity may yield prognostic information about risk for protracted recovery.
Within-Person Score Distribution Measures as Performance Validity Indicators in Service Members and Veterans with and without History of Mild Traumatic Brain Injury.
Davis JJ
Arch Clin Neuropsychol · 2026 Feb · PMID 41364546 · Publisher ↗
OBJECTIVE: This study examined within-person score distribution measures (WPSD) as a performance validity indicator using the overall test battery mean (OTBM), within-battery standard deviation (SD-B), coefficient of var...
OBJECTIVE: This study examined within-person score distribution measures (WPSD) as a performance validity indicator using the overall test battery mean (OTBM), within-battery standard deviation (SD-B), coefficient of variation (CV), number of abnormal scores (ABN), and several other measures. The primary aim was comparison of classification accuracy of various WPSD measures. METHOD: The study involved secondary analysis of de-identified data originally collected in the Chronic Effects of Neurotrauma Consortium Study 1. Participants (N = 1431) were categorized into valid and questionable performance validity groups using independent performance validity tests (PVTs). Seven WPSD measures were calculated from norm-referenced T scores on 24 cognitive tests: OTBM, CV, SD-B, kurtosis, skew, range, and ABN (scores ≤35 T). Area under the receiver operating characteristic curve (AUC) values were compared across WPSD measures. RESULTS: Significant group differences were observed in OTBM, CV, and ABN. AUC comparison showed excellent classification accuracy for OTBM (AUC = 0.83) and ABN (AUC = 0.84), and acceptable accuracy for CV (AUC = 0.74). Minimum specificity (≥90%) was shown with cutoffs on OTBM (≤42 T; sensitivity = 56%), CV (≥0.265; sensitivity = 30%), and ABN (≥6; sensitivity = 55%). Slight adjustments were required to maintain specificity in racially and ethnically diverse sample subsets. CONCLUSIONS: OTBM and ABN demonstrated strong potential for use as embedded PVTs with excellent classification accuracy. CV displayed lower classification accuracy with group differences primarily due to changes in mean performance rather than increased dispersion. Further development and cross-validation of WPSD-based PVTs is warranted in civilian samples.
Every Four-Legged Animal is Not a Dog: Investigating Concussive Symptoms in a Non-Concussed Psychiatric Sample.
Abrar K, Goldstein BM, Frank JB … +1 more , Zakzanis KK
Arch Clin Neuropsychol · 2026 Feb · PMID 41359410 · Full text
Persistent somatic, cognitive, and psychological symptoms following an uncomplicated mild traumatic brain injury are often attributed to post-concussion syndrome. However, existing research demonstrates that non-concusse...
Persistent somatic, cognitive, and psychological symptoms following an uncomplicated mild traumatic brain injury are often attributed to post-concussion syndrome. However, existing research demonstrates that non-concussed populations also report high base rates of such symptoms. In this study, archival data from 131 individuals with psychiatric diagnoses were analyzed using the Rivermead Post-Concussion Symptoms Questionnaire. Participants were classified into trauma- and anxiety-related disorders, somatic symptom and related disorders, or complex psychiatric disorders. Nonparametric tests were conducted to examine group differences in RPQ total and symptom cluster scores. Significant differences were observed across diagnostic groups, with the complex psychiatric disorders group endorsing the highest total and cluster scores. Across all psychiatric groups, mean RPQ total scores exceeded those reported in multicultural healthy controls and a mTBI sample. The present study demonstrates that PCS-like symptoms are not unique to neurological trauma but are strongly endorsed across psychiatric populations, particularly among individuals with multiple psychiatric comorbidities.
Comparing the Neuropsychology Knowledge Base of Publicly Available Large Language Models.
Kronenberger OR, Hutnyan M, Kaser AN … +3 more , Bullinger L, Lacritz LH, Cullum CM
Arch Clin Neuropsychol · 2026 Feb · PMID 41359409 · Publisher ↗
OBJECTIVE: Assess the neuropsychology knowledge base of open-access large language models (LLMs) and inform potential applications in the field. METHOD: We obtained 600 multiple-choice practice questions from the "Be Rea...
OBJECTIVE: Assess the neuropsychology knowledge base of open-access large language models (LLMs) and inform potential applications in the field. METHOD: We obtained 600 multiple-choice practice questions from the "Be Ready for ABPP in Neuropsychology" website of the American Academy of Clinical Neuropsychology. We tested OpenAI (GPT-3.5, GPT-4, o3-mini-high) and Google (Gemini 1.0, 2.0 Flash Thinking Experimental [FTE]) models in two trials (T1: used 20-question blocks, T2: single-item re-administration of incorrect questions during T1). We compared AI-estimated to actual accuracy using a paired-samples t-test, while binomial logit generalized linear mixed-effects models (GLMMs) with a random intercept for item compared LLMs and item-level predictors (domain of practice, word count, position-in-block, and higher/lower order question type). Finally, we thematically analyzed the questions missed by the top models. RESULTS: OpenAI o3-mini-high demonstrated the highest accuracy (T1:87.0%, T2:90.3%), followed by Gemini 2.0 FTE (T1:81.7%, T2:88.7%), GPT-4 (T1:74.0%, T2:85.5%), GPT-3.5 (T1:62.5%), and Gemini 1.0 (T1:52.3%). On average, LLMs overestimated their accuracy by 15.8% (87.3% vs. 71.5%, p < .001). In the GLMMs, specific LLM (p < .001) and practice domain (p = .045) were the only significant predictors of accuracy. Chain-of-thought "reasoning" models outperformed older models (p < .001) but displayed inaccuracies pertaining to aspects of neuropsychological testing and interpretation, diagnostic reasoning, clinical decision making, and neuroanatomy/neuroimaging. CONCLUSIONS: Chain-of-thought "reasoning" models displayed the highest accuracy, suggesting they may have utility in neuropsychology education, research, and clinical practice. However, the LLMs displayed persistent neuropsychology content area weaknesses and tended to present inaccurate information with confidence, highlighting the need for caution when interpreting LLM output.
The MINT Sprint 2.0: a Picture Naming Test for Detection of Naming Impairments in ΜCI Due or Not to AD, Greek Version.
Alopoudi A, Moraitou D, Tegos T … +1 more , Tsolaki M
Arch Clin Neuropsychol · 2026 Feb · PMID 41328904 · Full text
OBJECTIVE: Naming impairments are among the earliest cognitive deficits in Alzheimer's disease (ad), particularly affecting semantic memory and lexical retrieval. This study evaluated the diagnostic utility of the Greek...
OBJECTIVE: Naming impairments are among the earliest cognitive deficits in Alzheimer's disease (ad), particularly affecting semantic memory and lexical retrieval. This study evaluated the diagnostic utility of the Greek adaptation of the MINT Sprint 2.0, a culturally tailored picture-naming test, in identifying naming deficits in preclinical and early ad. METHOD: A total of 170 Greek-speaking participants were classified into three diagnostic groups: (1) MCI biomarker positive (preclinical ad), (2) MCI biomarker negative, and (3) cognitively intact (CI) (biomarker negative). Participants completed the MINT Sprint 2.0, comprising naming accuracy (MINTFIRSTPASS) and response latency (MINTFIRSTPASSTIME). Multivariate and univariate ANOVAs were used to assess group differences. RESULTS: Diagnosis significantly influenced performance across both measures, accounting for 26.5% of variance in accuracy and 52.7% in latency (p < .01). MANOVA revealed a large multivariate effect (Pillai's Trace V = 0.674, p < .01). Post hoc tests confirmed that all groups differed significantly on both variables, with biomarker-positive individuals performing worse and slower than other groups. MINT Sprint 2.0 elicited significantly different performance across diagnostic groups, supporting its potential utility in detecting early AD-related changes and offering enhanced sensitivity to early lexical retrieval deficits and response speed. Strong correlations between MINT Sprint and 15-BNT scores supported convergent validity. CONCLUSION: The Greek MINT Sprint 2.0 is a valid and sensitive tool for detecting early ad-related naming impairments. Its cultural relevance and inclusion of response time make it superior to traditional naming tests, offering potential as a primary screening measure in Greek-speaking populations.
Worrying about Concussions and Brain Health is Strongly Associated with Psychological Distress in Former Elite Rugby League Players.
Iverson GL, Smith OJ, Terry DP … +1 more , Gardner AJ
Arch Clin Neuropsychol · 2026 Feb · PMID 41324472 · Publisher ↗
OBJECTIVE: Former collision sport athletes may worry and ruminate about their brain health, which might contribute to psychological distress. We hypothesized there would be a strong association between being very worried...
OBJECTIVE: Former collision sport athletes may worry and ruminate about their brain health, which might contribute to psychological distress. We hypothesized there would be a strong association between being very worried about this and current psychological distress. METHOD: This cross-sectional study examined former elite/professional Australian rugby league players (n = 235; Mean age = 52.37) who completed the Depression, Anxiety, and Stress Scale-21 (DASS-21), Brief Pain Inventory, and Connor-Davidson Resilience Scale. On average, they played 8.65 years of rugby league professionally (SD = 4.68) and had 23.37 years of total lifetime rugby league participation (SD = 5.66). RESULTS: There were 29.8% who reported being very worried about the possible effects of past concussion(s) on their memory and thinking skills as they get older. There were 29.2% who reported moderate-severe depression, anxiety, or stress on the DASS-21. A logistic regression predicting moderate-severe psychological distress was significant (p < .001, Nagelkerke R2 = 0.37) and revealed that number of lifetime concussions (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.00-1.03), lifetime history of depression (OR = 3.20, 95% CI = 1.44-7.14), lower resilience (OR = 0.96, 95% CI = 0.93-0.99), and being very worried about their concussion history (OR = 3.29, 95% CI = 1.49-7.23) were independent predictors. Total years of participation in rugby league, years of participation at the professional level, and life interference due to chronic pain were not associated with psychological distress in the regression analysis. CONCLUSION: These results have implications for the psychological health and quality of life of former collision sport athletes. Providing a multimodal approach to treatment, including psychological interventions, prescribed exercise, and medications, might lead to considerable improvement in their psychological health and quality of life.
Handedness and Working Memory: Exploring Modality-Specific Effects.
Heled E, Asher G, Kenigsbuch M … +4 more , Yossef S, Shimon AS, Spiegelman S, Nataf H
Arch Clin Neuropsychol · 2026 Feb · PMID 41316992 · Publisher ↗
Working memory (WM) distinctions between right- and left-handers show inconsistent results in visual and verbal modalities. However, the tactual modality has not yet been assessed. The aim of the current study was to com...
Working memory (WM) distinctions between right- and left-handers show inconsistent results in visual and verbal modalities. However, the tactual modality has not yet been assessed. The aim of the current study was to compare right- and left-handers across the three modalities. Thirty-two right handers and thirty left handers participants performed the Digit Span, Visuospatial Span, and Tactual Span tasks, encompassing forward and backward recalls. Results showed no difference between left- and right-handers on overall WM ability, and Tactual Span scores were lower compared to the other tasks. Left-handers performed better on the forward Visuospatial Span but worse than right-handers on the backward Tactual Span. Findings indicate that hemispheric lateralization patterns associated with handedness yield modality-specific advantages, highlighting the importance of considering both modality and handedness in interpreting WM performance, with implications for refining neuropsychological assessment.
Interpreting Scores from Adolescents with Attention-Deficit/Hyperactivity Disorder on Sway Medical System Balance and Cognitive Modules.
Maietta JE, Santangelo JM, Cook NE … +1 more , Iverson GL
Arch Clin Neuropsychol · 2026 Jan · PMID 41283990 · Publisher ↗
PURPOSE: Many high schools in the United States conduct preseason "baseline" cognitive and balance testing as part of their concussion management procedures. Prior research has identified differences in cognitive and bal...
PURPOSE: Many high schools in the United States conduct preseason "baseline" cognitive and balance testing as part of their concussion management procedures. Prior research has identified differences in cognitive and balance test scores between youth with and without attention-deficit/hyperactivity disorder (ADHD). The present study examined whether preseason baseline scores on the Sway Medical System Balance and Cognitive Modules differed between adolescent athletes with self-reported ADHD and those without ADHD. METHOD: The Sway Medical System is a smartphone or tablet-based assessment that includes both cognitive and balance tests that can be administered at baseline and following concussion or suspected concussion. Cognitive and balance test results were examined from 23,566 adolescents (49.8% girls) between 14- and 18-year-old who underwent baseline testing during the summer of 2022. RESULTS: For both boys and girls, adolescents with ADHD obtained slightly worse scores on all four cognitive tests and the balance test (p values<.001). The effect sizes for these differences were very small-to-small (r = 0.04-0.07; Hedges' g = 0.13-0.22). CONCLUSION: Adolescents with self-reported ADHD had slightly lower scores on the Sway Medical System Balance and Cognitive Modules, with small-to-very small effect sizes that may be of limited clinical significance. The Sway Medical System currently provides normative data stratified by age and gender. Our results suggest that further stratifying by ADHD status may not be necessary for adolescents-although future research might reveal subgroups of children or young adults with ADHD that have larger score differences.
Sex Differences and Executive Function Profiles in Childhood Attention-Deficit/Hyperactivity Disorder: Evidence from Digital Neurocognitive Assessment.
Díaz-Moreno E, Heredia-Jimenez J
Arch Clin Neuropsychol · 2026 Feb · PMID 41269102 · Publisher ↗
OBJECTIVE: To test sex differences and executive-function (EF) heterogeneity in childhood attention-deficit/hyperactivity disorder (ADHD) using a standardized digital battery. METHOD: We studied 208 clinically referred c...
OBJECTIVE: To test sex differences and executive-function (EF) heterogeneity in childhood attention-deficit/hyperactivity disorder (ADHD) using a standardized digital battery. METHOD: We studied 208 clinically referred children aged 7-12 years with ADHD diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). CNS vital signs yielded 11 domains overall; all prespecified inferential analyses used 10 domains (Composite Memory excluded), with age as covariate and false-discovery-rate control (q = 0.05). Frequentist analysis of covariance were complemented by Bayesian information criterion (BIC)-based Bayes factors and two one-sided tests equivalence (|d| < 0.30). Heterogeneity was examined via k-means clustering on z-scored profiles (complete-case n = 170) with validation by silhouette and Adjusted Rand Index from hierarchical clustering. RESULTS: The multivariate sex effect was not significant (Pillai's trace = 0.04, p = .74). After false discovery rate (FDR) control, only Psychomotor Speed and Motor Speed differed, favoring boys (Psychomotor Speed: F = 11.43, q = 0.005, η2p = 0.053, d = 0.48; Motor Speed: F = 21.82, q < 0.001, η2p = 0.097, d = 0.66). For Complex Attention, Cognitive Flexibility, Executive Function, Simple Attention, Processing Speed, Reaction Time, Verbal Memory, and Visual Memory, between-sex differences were not reliable and Bayesian evidence typically supported similarity (BF₀₁ ranged from 3 to 13). Clustering produced three severity-graded EF profiles (n = 48/39/83; average silhouette = 0.17) with moderate cross-method agreement (Adjusted Rand Index = 0.55) and no association with sex or DSM-5 presentation. Sensitivity analyses (additional covariates, exclusions, construct-level indices, and 11-domain clustering) were convergent. CONCLUSIONS: Boys and girls with ADHD show largely similar EF architectures, with small speed-specific differences favoring boys. EF heterogeneity is captured by three severity-graded profiles that transcend sex and DSM-5 presentations, supporting dimensional, performance-based assessment.
Investigating the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Executive Errors Scale in Adults With Schizophrenia Spectrum Disorders.
Raudeberg R, Iverson GL
Arch Clin Neuropsychol · 2026 Feb · PMID 41251466 · Publisher ↗
OBJECTIVE: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief neuropsychological screening battery that measures aspects of attention, immediate and delayed memory, and verbal and v...
OBJECTIVE: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief neuropsychological screening battery that measures aspects of attention, immediate and delayed memory, and verbal and visuospatial-constructional abilities. An embedded measure of executive functions, the RBANS Executive Errors Scale (RBANS EE), has been developed as a supplementary RBANS scale. The RBANS EE reportedly has good concurrent validity and is useful for screening for executive dysfunction in U.S. military veterans, but its usefulness has not been investigated in other clinical samples. The aim of the current study is to investigate the RBANS EE scores in people with schizophrenia spectrum disorders. METHOD: Archival data from a sample of 241 participants with a mean age of 24.40 (SD = 5.62) years and a mean of 12.58 (SD = 1.85) years of education were analyzed. A global measure of executive functioning symptoms and problems, the Global Executive Composite (GEC) of the Behavior Rating Inventory of Executive Function-Adult Self-Report Version (BRIEF-A SR) was used as a criterion measure, and two versions of the RBANS EE scale were examined. RESULTS: Only 1%-3% met criteria for executive dysfunction on the two RBANS EE versions. The BRIEF-A SR GEC did not predict error likelihood or error severity on either of the RBANS EE versions. CONCLUSIONS: In sum, we did not replicate the findings reported in previous investigations of the RBANS EE in this sample of adults with schizophrenia spectrum disorders.
Evaluating an Adaptive, Web-Based Training Program for Teaching Older Adults Experiencing Cognitive Difficulties to Use an Electronic Memory and Management Aid.
Li X, Beech BF, Hales T … +8 more , Van Son C, Chilton R, Lujan C, Duell B, DeSmet C, Cook D, Johnson RK, Schmitter-Edgecombe M
Arch Clin Neuropsychol · 2026 Jan · PMID 41231083 · Publisher ↗
OBJECTIVE: Older adults with cognitive concerns can benefit from technology-based compensatory strategies to support independent functioning, but in-person training can be costly and difficult to scale. Web-based trainin...
OBJECTIVE: Older adults with cognitive concerns can benefit from technology-based compensatory strategies to support independent functioning, but in-person training can be costly and difficult to scale. Web-based training offers a promising alternative to scale technology adaptation and increase access of digital tools. This paper describes the iterative development and evaluation of an adaptive, web-based training program designed to help older adults learn to use an Electronic Memory and Management Aid. METHODS: Participants were community-dwelling older adults across a continuum of cognitive difficulties. In Study 1, two pilot iterations were conducted to evaluate user satisfaction and collect ground truth data for the machine learning algorithm supporting adaptive training. In Study 2, participants completed the training program in the context of a clinical trial, and qualitative data from semi-structured interviews were analyzed to identify successes and barriers associated with the program.. RESULTS: In Study 1, participants reported high satisfaction with the training program. Their feedback was used to iteratively refine the content and structure, while clinician observations provided ground truth data that informed the development and enhancement of the adaptive algorithm. In Study 2, participants highlighted positive experiences with multiple features that supported individualized learning, including adjustable pacing, content repetition, practical quizzes, and exercises that facilitated integration of the memory aid into daily routine. CONCLUSIONS: This study demonstrates the feasibility of using web-based training to scale the use of technology-based compensatory strategies by older adults with varying cognitive abilities. Features that support adaptive learning are essential for maximizing engagement and effectiveness.
A Cross-Sectional Examination of the Relationship between Subjective Self-Regulatory Difficulties and Functional Outcomes among Veterans with and without Traumatic Brain Injury.
McDonald MA, Kimbrel N, Hurley RA … +2 more , Kennerly R, Shura R
Arch Clin Neuropsychol · 2026 Feb · PMID 41208683 · Publisher ↗
OBJECTIVE: To test if subjective self-regulatory difficulties correlate with functional outcomes, and to test for group differences in self-regulatory abilities and functional outcomes between Veterans with and without a...
OBJECTIVE: To test if subjective self-regulatory difficulties correlate with functional outcomes, and to test for group differences in self-regulatory abilities and functional outcomes between Veterans with and without a history of traumatic brain injury (TBI). METHOD: All Personality Assessment Inventory (PAI) protocols administered in the VA electronic system (N = 36,830) were pulled. Invalid PAI protocols were excluded, resulting in a sample size of N = 30,171. Of these, 1,933 had either a visit diagnosis of or service connected disability related to TBI. We conducted non-parametric tests of correlations and group differences while statistically adjusting for demographics. RESULTS: Nearly all statistical tests were significant, even after accounting for multiple comparisons. Therefore, we focused on findings with large effect sizes. Strong correlations were observed among self-reported self-regulatory difficulties as well as between self-regulatory difficulties and functional outcomes. Notably, self-reported difficulties with emotion regulation (Affective Instability, BOR-A), inattention/disinhibition (Inattention Index), and general cognitive complaints (Thought Disorder, SCZ-T) were all associated with an indicator of future suicide attempt risk (Suicide Potential Index; ρs = .66-.78). Across all variables, effect sizes for TBI vs non-TBI comparisons were very small (${\eta}_p^2$s ≤ .003) and thus not practically significant. CONCLUSIONS: Subjective self-regulatory difficulties, including emotion regulation difficulties, were associated with worse functional outcomes, and no meaningful differences were found between Veterans with vs without TBI. Therefore, results support the utility of addressing subjective self-regulatory complaints, regardless of the presence of objective cognitive deficits and/or TBI history, in treatment and rehabilitation efforts (e.g., cognitive rehabilitation).
Trends in Public Knowledge Pertaining to Traumatic Brain Injury From 2016 to 2025.
Merz ZC, Van Patten R, Lace J … +3 more , Hoots JK, Chan L, Cook NE
Arch Clin Neuropsychol · 2026 Feb · PMID 41206368 · Publisher ↗
OBJECTIVE: Prior literature suggests that misconceptions surrounding traumatic brain injury (TBI) definition, short-term impact, and long-term implications are common. The current study sought to replicate and expand a p...
OBJECTIVE: Prior literature suggests that misconceptions surrounding traumatic brain injury (TBI) definition, short-term impact, and long-term implications are common. The current study sought to replicate and expand a previous survey to provide updated estimates regarding the frequency of TBI misconceptions within lay individuals from the United States. METHOD: Data were collected from 438 individuals via an electronic survey. Participants completed 42 items designed to evaluate knowledge surrounding TBI. RESULTS: The overall accuracy rate/percent answered correctly was 60%. Participants who reported having attended a seminar/workshop taught by an expert on concussion or having received formal concussion training (58%) demonstrated somewhat worse accuracy relative to those with no reported training (62%; p = .004). Participants who reported above average or greater exposure to discussion of head injuries and their outcomes in the media (58%) demonstrated slightly worse accuracy relative to those who reported average media exposure or less (61%; p = .013). There were no significant differences in accuracy between participants who: (i) reported having been formally diagnosed with ≥1 concussion by a healthcare professional, compared to those without a concussion history; (ii) reported any formal athletic participation relative to those without athletic participation; and (iii) participated in contact sports compared to those who did not. CONCLUSIONS: High rates of TBI misconceptions remain and individuals remain vulnerable to the impact of the spread of misinformation across mass and social media.
Validation of a Web-Based Digit Symbol Substitution Task for Detection of Mild Cognitive Impairment in Older Adults.
Fernandez DA, Scott BM, Kheradbin N … +5 more , Guadagno L, Gade S, Schmitz S, Keller JN, Hilsabeck RC
Arch Clin Neuropsychol · 2026 Feb · PMID 41189112 · Publisher ↗
OBJECTIVE: Given the global aging of society and projected increases in cognitive impairment, rapid and sensitive cognitive screening tests are needed to facilitate early detection of mild cognitive impairment (MCI) in o...
OBJECTIVE: Given the global aging of society and projected increases in cognitive impairment, rapid and sensitive cognitive screening tests are needed to facilitate early detection of mild cognitive impairment (MCI) in older adults. The purpose of this study was to explore the effectiveness of a web-based digit symbol substitution task, Speeded Matching (SM), including a second administration within-session to determine the added utility of practice effects, for potential use as a cognitive screening measure in older adult populations. METHOD: Forty-seven older adults with MCI and 87 cognitively normal controls (NC) completed SM twice on an iPad, as well as a brief paper-and-pencil cognitive screening test, the Quick MCI (Qmci). Receiver operating characteristic (ROC) curve analyses were used to investigate the classification accuracy of both administrations of the SM and the Qmci. The incremental validity of the second administration of SM was examined using logistic regression analysis. RESULTS: Patients with MCI performed significantly worse than their NC counterparts on all measures. NC participants also demonstrated significantly greater practice effects than those with MCI. ROC curve analyses indicated that a cutoff score of <24 for the first administration (AUC = 0.82) and < 27 for the second administration (AUC = 0.85) of SM had slightly better classification accuracy than the Qmci (AUC = 0.77), and a second administration of the SM task within-session significantly improved overall classification accuracy. CONCLUSIONS: Findings suggest that a rapid web-based digit symbol substitution test is a valid screening measure that performs as well as a traditional cognitive screening test.
TQ-DAV: Action Naming Test with Videos for Quebec French.
Spigarelli M, Bergeron-Houde L, Taillon R … +1 more , Wilson MA
Arch Clin Neuropsychol · 2026 Jan · PMID 41168670 · Full text
OBJECTIVE: The difficulty to retrieve verbs (verb anomia) is common in people with post-stroke aphasia. Verb anomia assessment often relies on picture oral naming task. However, oral naming of videos better captures the...
OBJECTIVE: The difficulty to retrieve verbs (verb anomia) is common in people with post-stroke aphasia. Verb anomia assessment often relies on picture oral naming task. However, oral naming of videos better captures the intrinsic dynamics of actions. METHODS: This observational study reports the development of the Test québécois de dénomination d'actions par visionnement de vidéos (TQ-DAV) [Action Naming Test with Videos for Quebec French], designed to assess verb anomia in the French-speaking individuals of Quebec, Canada. The TQ-DAV consists of 20 action videos (10 high-frequency and 10 low-frequency actions), matched on several psycholinguistic variables. RESULTS: TQ-DAV shows robust psychometric properties. It allows to differentiate the performance of healthy people and that of people with post-stroke aphasia (discriminant validity). The TQ-DAV demonstrates good internal consistency. The norms of the TQ-DAV allow to easily and automatically calculate the Z-score and the frequency effect of a person. CONCLUSION: In sum, the TQ-DAV enriches the tools for assessing verb anomia in Quebec French people.
Cognitive and Motor Improvements Correlated with Sleep and Activity Following Community-Based Non-contact Boxing in Patients with Parkinson Disease.
Leguizamon M, Trujillo P, Hett K … +10 more , McKnight CD, Ponzo T, Elenberger J, Song AK, Bridges C, Yan B, Kang H, Donahue MJ, Claassen DO, Considine CM
Arch Clin Neuropsychol · 2026 Feb · PMID 41165167 · Full text
OBJECTIVE: To evaluate the feasibility of a 12-week community-based, non-contact rock-steady-boxing (RSB) program in individuals with Parkinson disease (PD) and to assess potential improvements in motor and cognitive fun...
OBJECTIVE: To evaluate the feasibility of a 12-week community-based, non-contact rock-steady-boxing (RSB) program in individuals with Parkinson disease (PD) and to assess potential improvements in motor and cognitive functioning after intervention. METHOD: Over 12 weeks, 26 PD participants completed 24 RSB classes. Motor and cognitive assessments were conducted at baseline and follow-up, with a sub-group (n = 14) wearing clinical actigraphy. Linear mixed-effects models investigated compliance and changes in motor and cognitive functions. Multiple linear regression assessed correlations of clinical changes with clinicodemographic factors and actigraphy variables (two-sided p < .05). RESULTS: PD participants showed significantly improved motor performance on the Mini Balance Evaluation Systems Test following RSB (p < .01, β = 0.69, 95% C.I. [0.40, 0.99]). No significant cognitive improvements were observed after false discovery correction, though higher scores with moderate effect sizes were suggested on HVLT-Total Recall (p = .23, β = 0.30, 95% C.I. [0.033, 0.58]), HVLT-Delayed Recall (p = .23, β = 0.25, 95% C.I. [0.03,0.46]), Stroop-Color (p = .23, β = 0.26, 95% C.I. [0.04, 0.48]), and Stroop-Interference tests (p = .15, β = 0.39, 95% C.I. [0.13, 0.64]). No significant changes were observed for actigraphy-based activity and sleep metrics. Exploratory analysis provided effect sizes and confidence intervals of associations between actigraphy variables and clinical assessments. CONCLUSIONS: RSB intervention led to better motor functioning and potential, though uncertain, cognitive benefits independent of age, sex, or disease severity. Cautious interpretation of exploratory analyses suggests changes in activity and sleep may relate to motor and cognitive changes following RSB. Findings support compliance with RSB in PD and motivate larger, randomized trials investigating the role of exercise in facilitating PD symptom improvement.
Precision Neuromodulation for Diabetes-Associated Cognitive Decline: a Transcranial Electrical Stimulation Approach.
Mohammadi R, Alipour A
Arch Clin Neuropsychol · 2026 Feb · PMID 41165160 · Publisher ↗
BACKGROUND: Type 3 Diabetes (T3DM), marked by brain insulin resistance, is increasingly linked to neurocognitive decline and Alzheimer's pathogenesis, necessitating novel non-pharmacological interventions. This study inv...
BACKGROUND: Type 3 Diabetes (T3DM), marked by brain insulin resistance, is increasingly linked to neurocognitive decline and Alzheimer's pathogenesis, necessitating novel non-pharmacological interventions. This study investigated anodal transcranial direct current stimulation (tDCS) targeting the left DLPFC (F3 region) to improve cognitive deficits in insulin-dependent diabetic patients with diabetes-associated cognitive decline (DACD). METHODS: This study utilized a randomized, double-blind, two-group clinical trial design. Diabetic patients aged 60-80 years in Tehran and Bonab experiencing brain fog and cognitive decline constituted the target population. Recruitment and execution occurred from autumn 2024 to spring 2025. A purposive sampling method selected 23 matched participants per group, adhering to strict inclusion/exclusion criteria. Participants were then randomly assigned to either the experimental or control group. The experimental group received 30 tDCS sessions. Cognitive status and memory were assessed using the mini-mental state examination as the primary outcome and the prospective and retrospective memory questionnaire as a supplementary measure. Repeated Measures ANOVA analyzed the data. RESULTS: The results indicated that tDCS administered to the DLPFC in the experimental cohort significantly enhanced overall cognitive function and reduced subjective memory complaints (p < .01). Additionally, a statistically significant reduction in glycated hemoglobin was observed across nearly all participants in the experimental group (p < .01). CONCLUSION: These findings indicate that tDCS presents a promising, non-invasive therapeutic approach. It demonstrates potential for enhancing cognitive function in patients with DACD and for facilitating improved long-term glycemic control. This highlights the role of brain neuromodulation as a component in the management of diabetes-related complications.
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