Journal of clinical and experimental neuropsychology最新文献

The new Chinese version of the SKT (Syndrom-Kurz-Test) Short Cognitive Performance Test aims to detect early cognitive impairment and is a promising addition to neuropsychological test batteries in China and suitable for Chinese speaking patients. This study has three aims: 1. to assess whether the SKT's diagnostic accuracy is comparable to established cognitive impairment tests (e.g. Addenbrooke´s cognitive examination-III (ACE-III) and Montreal Cognitive Assessment-Basic (MoCA-B)); 2. to examine whether the three tests show intra-individual differences according to different types of mild cognitive impairment (single-domain amnestic MCI, semantic MCI and multiple-domain amnestic MCI); 3. to determine whether these tests distinguish between individuals with no cognitive impairment and those with subjective cognitive decline (SCD). The validation sample included 1038 older adults (mean age = 70.04, SD = 6.05) from the Chinese Preclinical Alzheimer's Disease Study (C-PAS). Participants underwent cognitive testing and received consensus diagnoses of normal cognition, MCI, or dementia. Sensitivity and specificity were calculated for each test. ANOVAs examined differences between MCI subtypes, and t-tests assessed group differences between normal cognition and SCD. Results: The SKT showed the highest discrimination between normal cognition and cognitive impairment (MCI or dementia), with a sensitivity of 85.4% and specificity of 69.8%. All three tests demonstrated significant score differences across MCI subtypes. Additionally, all tests significantly distinguished individuals with SCD from those without cognitive impairment (p < 0.01). Conclusions: The new Chinese produced weaker results than the established tests. However, given its strengths, it could be a useful tool for identifying cognitive impairment in certain situations.

Background: Women face disproportionately high Alzheimer's disease (AD) rates, with Latina women experiencing particularly elevated cognitive impairment rates. Understanding reproductive factors' impact on brain aging is critical for this underrepresented population. Given sex disparities in AD and reproductive factor influence on brain aging, we examined relations among reproductive history, white matter integrity, and cognitive function in post-menopausal Latina women.

Methods: Participants were 95 post-menopausal Latina women from the Boston Latino Aging Study, mean age 65.7 (SD = 6.5) years and 11.7 (SD = 4.8) years of education. Reproductive history was obtained via self-report questionnaire. Cognitive assessment included Mini-Mental State Examination, Free and Cued Selective Reminding Test, Category Fluency, Story Memory Delayed Recall, and Symbol Digit Modalities Test administered in Spanish or Portuguese. White matter microstructure was assessed with diffusion weighted imaging using fixel-based methods. Regression models tested associations among reproductive factors, cognitive and imaging outcomes, adjusting for age, education, and cardiovascular risk. Mediation analyses evaluated whether white matter abnormalities explained reproductive-cognitive relations.

Results: Pregnancy history was associated with worse delayed recall, with women having 1-2 (β = -0.79, p = .016) and 3-4 term pregnancies (β = -0.93, p = .005) performing worse than nulliparous women. Overall, hormone replacement therapy use was associated with better delayed recall (β = 0.58, p = .037). White matter analyses revealed trends suggesting pregnancy-related reductions in fiber density and cross-section across multiple tracts, with 3-4 term pregnancies showing most consistent patterns. Hysterectomy showed trends toward higher fiber density in several tracts. Mediation analyses indicated white matter integrity did not account for reproductive-cognitive associations.

Conclusions: Reproductive history, particularly pregnancy number, is associated with cognitive performance and white matter microstructure in post-menopausal Latina women. These findings underscore the importance of considering reproductive factors in AD risk assessment and highlight the need for longitudinal studies to clarify mechanisms driving these associations.

Background: Hyperbaric oxygen (HBO₂) treatment is used to treat a variety of conditions, but its effects on cognitive functioning are inconsistently assessed. This scoping review identifies the current literature on cognitive testing in relation to HBO₂ treatment.

Objective: We aimed to 1) identify which cognitive domains have been investigated in relation to HBO₂; 2) identify the neurocognitive tests used; and 3) propose a standardized cognitive assessment program applicable to future HBO₂ clinical trials.

Methods: A systematic search of four databases was conducted up to March 2025 for clinical studies involving adult patients treated with HBO₂, with neurocognitive testing as one of the outcomes. Cognitive domains were categorized using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, and test sensitivity was evaluated in randomized controlled trials.

Results: Of 3,238 records, 98 studies published between 1963 and 2025 met the inclusion criteria. The findings reveal considerable variation in the cognitive domains investigated and in the assessment methods employed, reflecting the diversity of disorders treated and a lack of consensus in the field of HBO₂ treatment. To improve consistency and comparability across future HBO₂ research, we propose a standardized, computerized cognitive test battery assessing psychomotor speed, attention, memory, and executive function.

Objective: People who struggle to provide verbal responses may be underserved by neuropsychology. A nonverbal cognitive test (NCT) was developed to fill this need. Reliability, concurrent validity, criterion-related validity, and clinical utility are presented.

Method: The NCT and neuropsychological tests were administered to 122 adults aged 19-91, including 87 healthy adults (CN) and 35 adults with cognitive impairment (CI) meeting diagnostic criteria for a neurocognitive disorder. The overall sample was used to determine internal consistency and concurrent validity of the NCT (Experiment 1). The criterion-related validity and clinical utility of the NCT were assessed among the above 35 older adults with CI and 49 older adult CN participants with similar age and education (Experiment 2).

Results: The NCT (alpha = .84) is internally consistent. Seven NCT subtests assessing learning, recall, attention, and working memory demonstrated concurrent validity (r's > .6) with neuropsychological tests. CN outperformed people with CI on the NCT and all subtests. Receiver Operating Characteristic shows a large area under the curve (.98). A cut-score of 75.5 differentiated people with CI from CN (true positive rate = .91; false positive rate = .04).

Conclusions: The NCT demonstrates acceptable psychometric properties and clinical utility for use as a cognitive test.

Research serves as the foundation of clinical neuropsychology, and strengthening research training pipelines is critical to sustaining innovation and scientific rigor within the field. Clinical assessment databases are one promising tool for achieving this goal. Herein, we describe the benefits and challenges of implementing clinical assessment databases across various neuropsychology training settings. First, we highlight their benefits, including the promotion of a standardized approach to clinical training, improvements in patient care, and increased opportunities for research. Next, we describe how clinical databases can be implemented across various training settings, including university-affiliated psychology training clinics, academic medical centers, Veterans Affairs hospitals, and private practice settings. The potential roles of faculty, trainees, and administrative staff in supporting database development and use are discussed. Lastly, we address practical strategies for overcoming implementation challenges, such as balancing both clinical and research demands, obtaining institutional review board approval, selecting appropriate data storage platforms, and ensuring data quality and consistency. Specific recommendations regarding platform storage are provided along with cost considerations. By integrating clinical assessment databases, neuropsychology training clinics can enhance their ability to provide evidence-based clinical training, deliver high quality care, and enhance research training. Although implementing clinical databases presents technical, logistical, and ethical challenges, these can be managed with careful planning.

Introduction: Competent patient care requires managing burnout in professionals, yet trainees face a unique set of stressors (e.g., balancing academic responsibilities with clinical work, teaching, mentorship, research, etc.). Burnout in neuropsychology trainees remains unstudied. This study assessed burnout levels in neuropsychology trainees to evaluate their severity and guide prevention and intervention efforts.

Methods: Neuropsychology doctoral students (n = 169, M_age = 29.22) and postdoctoral fellows (n = 12, M_age = 32.23) completed a demographic/training survey and the Copenhagen Burnout Inventory, measuring personal, work, and patient burnout (0-100 scale; higher = greater burnout). MANOVA and chi-square tests analyzed demographic/training data; MANCOVA assessed burnout differences, and Pearson correlations examined links between demographics, training, and burnout.

Results: Respondents reported moderate personal (M = 59.43, SD = 19.22) and work burnout (M = 56.64, SD = 18.30), and mild patient burnout (M = 34.57, SD = 18.71). MANCOVA showed no burnout differences across demographics, subspecialties (p = .41, partial η2 = .020), or training years (p = .28, partial η2 = .031). More years in training correlated with fewer activities (r(158) = -.457, p < .001), but activity level wasn't linked to burnout.

Discussion: Neuropsychology trainees showed burnout levels similar to professionals, with no significant differences across demographics or subspecialties. Activity levels declined with training progression, but burnout remained consistent, indicating comparable burnout across trainees. Preventative strategies like self-care and mindfulness are essential for supervisors to recognize and support trainees' well-being and quality of patient care.

Introduction: The field of neuropsychology is undergoing notable changes, especially in the context of the Minnesota Update Conference (MNC) guidelines draft development. In late 2023, a group of neuropsychology trainee-leaders, united through the Clinical Neuropsychology Trainee Forum (CNTF), surveyed neuropsychology trainees in the United States and Canada to better understand their needs and their perception of the current training climate.

Method: Survey items were drafted by a CNTF task force consisting of trainee-leaders from major neuropsychology organizations before being refined by four independent neuropsychologists. The survey was distributed via listservs and social media. Survey results were analyzed using frequency descriptives and analyses of variance to compare differences in responses based on demographic and training-related factors.

Results: Respondents who completed a majority of the survey (n = 220) were primarily female (86%), White (71%), and training in the United States (92%). More than 75% of respondents reported satisfaction with their doctoral program, internship, and/or fellowship. Similarly, 90% and 73% of the respondents, respectively, felt their opinions on the future of the field listened to and/or valued in discussions with peers and supervisors/mentors. However, only 57% of the respondents felt their opinions were valued by neuropsychology organizational leadership, and approximately 30% of the respondents agreed that trainees' opinions were valued during the MNC draft development review period. Another 40% of the respondents were uncertain about trainee perspectives being valued during the MNC process.

Conclusions: Most neuropsychology trainees are satisfied with their training, yet they expressed concerns about their opinions on the future of the field being heard by neuropsychology leadership. Trainee stakeholder engagement will be important to the vitality of neuropsychology in light of anticipated MNC Guidelines. Recommendations for the field of neuropsychology to support trainees will be discussed.

Objective: Advocacy has been identified as an important aspect of professional practice and identity in many subfields of health professions and science, including clinical neuropsychology. Despite this, opportunities for doctoral students to develop concrete skills related to advocacy and leadership more broadly within the specialty are sparse.

Method: An exploratory pilot survey was conducted to better understand neuropsychologists' prior training experiences with advocacy and leadership and their perspectives on how and when training should be provided. Sixty-eight neuropsychologists across career stages who self-identified as having had leadership or governance positions in psychology completed the survey. Thematic analysis of open responses was undertaken to identify primary themes related to training and education in advocacy and leadership.

Results: The majority of respondents (77.3%) were interested in receiving formal training or mentorship in advocacy/leadership. Even among neuropsychologists in formal leadership or governance positions, the majority had never participated in formal training opportunities in advocacy (76.5%) or leadership (60.3%), although most endorsed having received informal training and mentorship in leadership (76.5%). Most respondents believe that training should begin during doctoral training or earlier (68.7%). Perceived benefits of training include increased professional competency and relationships, while drawbacks included the time and cognitive cost of participation as well as limitations in the content and perspectives shared.

Conclusions: These results highlight the importance of advocacy in neuropsychology training, as well as the current limited access to training opportunities. While engaging in this work may require some flexibility, creativity, and self-advocacy on the part of doctoral students, there are many ways for trainees and mentors to leverage existing skills and professional organizations to support trainees in developing advocacy competency. Specific recommendations for the integration of such training into doctoral training and case vignettes highlighting advocacy in action during doctoral training are provided.

Introduction: By 2050, the U.S. population is projected to become increasingly heterogeneous, requiring a culturally competent neuropsychology workforce equipped to serve this evolving demographic. International graduate trainees bring valuable cultural and linguistic assets to the field of clinical neuropsychology but face significant structural barriers involving restrictive immigration policies.

Methods: This paper explores structural and institutional challenges by presenting results from a survey of 118 training directors across doctoral (n = 40), internship (n = 50), and postdoctoral (n = 28) levels, alongside personal narratives from four international trainees.

Results: Results reveal low international trainee enrollment - particularly at the postdoctoral level - and widespread immigration-related challenges, such as limited visa sponsorship and duration, unawareness of visa-related training restrictions, and discomfort among directors in supporting visa issues. Despite the potential benefits of STEM designation for clinical and counseling psychology programs to ease visa barriers, few programs have attempted and succeeded in this process. Personal narratives also highlighted the burdensome STEM conversion process, and the role of trainee-led efforts in overcoming bureaucratic hurdles.

Conclusions: To urgently address these issues, we advocate for systemic reforms including national-level STEM reclassification of psychology programs, extended visa durations, enhanced national pipelines and institutional support for visa sponsorship, and improved education on immigration policies. These efforts align with the Multicultural Orientation (MCO) model and AACN's Relevance 2050 goals by fostering a culturally and linguistically responsive workforce equipped to meet evolving mental health needs and to ensure the continued relevance of clinical neuropsychology.