Cognitive function is a significant predictor of daily functioning in the population, yet the extent to which common mental health symptoms account for this relationship remains unclear.

This study aimed to examine the relationship between cognition, mental health and functioning across two cohorts.

Participants were recruited from an online population cohort, HealthWise Wales (N = 3679), and a psychiatric cohort, the National Centre for Mental Health (NCMH, N = 1036), to complete a cognitive battery and the World Health Organization Disability Assessment Schedule (WHODAS). We assessed the associations between cognitive performance and the WHODAS, as well as two measures of life functioning: current employment and cohabitation with a partner. We examined the role of current mood, psychiatric and neurodevelopmental history and lifestyle factors using linear and logistic regression.

Higher cognitive performance was associated with fewer functional difficulties on the WHODAS (HealthWise Wales: B = −0.12, 95% CI (−0.15,−0.09), P < 0.001; NCMH: B = −0.1, 95% CI (−0.13,−0.08), P < 0.001), being in employment or education (HealthWise Wales: odds ratio 1.22, 95% CI (1.11,1.34), P < 0.001; NCMH: odds ratio 1.31, 95% CI (1.19,1.46), P < 0.001) and living with a partner (HealthWise Wales only: odds ratio 1.19, 95% CI (1.06,1.32), P = 0.003). Higher levels of depression and anxiety symptoms were consistently associated with reduced functioning across all analyses. The relationship between cognition and functioning remained significant but attenuated after accounting for these symptoms.

Cognitive function was associated with functioning in both clinical and population-derived samples. Current symptoms of depression and anxiety play a key role in this relationship. Both cognitive function and common mental health problems may be potential intervention targets to alleviate daily difficulties.

Cognitive impairment is associated with language changes that emerge during verbal responses to neuropsychological assessments that traditional scoring does not capture. The current study investigated the utility of a linguistic analysis of paragraph recall responses for detecting cognitive impairment.

Digital voice recordings of logical memory (LM) were available from 598 Long Life Family Study participants with normal cognition and 112 with cognitive impairment. Linguistic polyfeature scores for immediate (PFS-IR) and delayed recall (PFS-DR) were created from weighted sums of features associated with cognitive impairment. Logistic regression models assessed the predictive value of each PFS for classifying cognitive impairment. Repeated measures models with generalized estimating equations assessed whether PFSs predict cognitive screener performance over time.

Twelve linguistic features and higher PFSs were associated with cognitive impairment (PFS-IR OR = 1.05; PFS-DR OR = 1.07). PFS-DR scores approximated the accuracy of traditional LM scoring (AUC-PR = 0.77 vs. 0.81, respectively). A higher PFS-DR was also associated with lower cognitive screener scores over an average of 7 years of follow-up (β = –0.08, 95% CI [–0.11, –0.06]).

Quantification of linguistic features from paragraph recall identified distinct linguistic markers that reflect differences in learning, retention, and self-monitoring. Summary feature scores detected cognitive impairment and predicted lower cognitive performance over time. This approach has potential implications for automated testing, recording, and scoring pipelines allowing for implementation of gold-standard neuropsychological assessments in broader clinical and research settings. Further studies are needed to validate these findings across clinical and community-based populations.

More than two decades ago, normative data for two interference indices (Error Interference Effect, EIE; Time Interference Effect, TIE) from a short form of the Stroop Color–Word Test (SCWT-SF) were established in Italy. The present study aimed to update the normative data for the Italian SCWT-SF by extending the assessment beyond interference indices to include completion times and error counts across the three task conditions, namely Word Reading (W), Color Naming (C), and Color–Word Interference (CW), and to provide evidence supporting its construct validity.

N = 317 healthy adults (195 females; age: 62.79 ± 11.97 years, range = 40–89; education 13.17 ± 4.03 years, range = 5–23) completed the SCWT-SF (3 color; 30 items per condition) and a test battery assessing processing speed (Psychomotor Speed Test; Trail-Making Test – Part A) and executive functioning (EF) (Saccade and Antisaccade Test; Digit Ordering Test; Trail-Making Test – Part B). Norms were derived for each SCWT-SF measure using the Equivalent Score method. Correlational analyses explored construct validity.

Older age and lower education negatively affected SCWT-SF scores. Female sex was associated with lower completion times on C condition. No predictors emerged for errors in W condition. Word-reading and color-naming outcomes were associated with measures of processing speed, while the CW condition and interference indices with tests of inhibitory control, working memory, and set-shifting.

We provided updated, regression-based normative data for the Italian SCWT-SF, encompassing individual scores across its three conditions and the original interference indices, and evidence supporting its convergent validity with measures of processing speed and EF.

Few studies have examined the relationship between racial identity and baseline assessment performance in collegiate athletes, and even fewer have contextualized results using structural factors linked to test performance. This study examined racial differences in baseline assessment performance before and after controlling for performance on a word-reading task as a proxy for education quality. We hypothesized that there would be racial differences in baseline performance but that controlling for education quality would reduce these differences.

For this observational cross-sectional study, 875 collegiate athletes were grouped based on racial identity (White = 661, Black = 165, Another Race = 49) and underwent a comprehensive neuropsychological battery. Cognitive composite scores and intraindividual variability (IIV) were calculated for two neurocognitive domains: attention/processing speed and memory. Education quality was assessed with the Wechsler Test of Adult Reading (WTAR). ANCOVAs were used to examine racial differences in these cognitive domains before and after controlling for WTAR scores.

There were significant racial differences in both composite scores and in attention/processing speed IIV, p’s < .001, f = 0.13–0.21. However, there were no significant racial differences in memory IIV, p = .97. After controlling for WTAR scores, there were no significant racial differences in the attention/processing (p = .530, f = 0.03) or memory (p = .183, f = 0.06) composite scores, and the relationship between racial identity and attention/processing speed IIV was less prominent (p = .014, f = 0.10).

Results suggest that racial differences at baseline assessment can be largely accounted for by education quality as assessed by the WTAR, which underscores the importance of considering sociocultural context when assessing racially diverse athletes.

Neuropsychological (NP) tests are multi-domain in execution. Reliance on a single score representing specific domains obscures the detection of subtle cognitive changes and increases risk of inaccurate assessment. Rooted in the Boston Process Approach (BPA), the Framingham Heart Study (FHS) captures multi-dimensional errors and process features within and across NP tests. We examined these BPA variables in community-dwelling older adults.

We analyzed data from 2363 dementia-free participants aged 60 and above. Exploratory and confirmatory factor analyses used Kemeny covariance structures. Measurement invariance was estimated across age, sex, and education groups. We assessed the impact of demographics on latent factors, and the ability of these factors to predict future conversion to all-cause dementia. We trained machine learning (ML) models to compare NP and BPA data.

Participants were older adults (mean age 71.5 ± 8.7 years), primarily female (54.2%), and non-Hispanic White (96.5%). The bifactor model was the only model with adequate fit (CFI = 0.96, RMSEA = 0.03). General and specific factors captured ability for accurate and strategic responses, test-specific variance, and nuanced executive and semantic processes distributed across tests. Higher general ability and stronger verbatim story recall were associated with a reduced likelihood of developing all-cause dementia (general: OR = 0.15, 95% CI [0.12–0.86]; recall: OR = 0.24, 95% CI [0.23–0.90]) over a median of 5.2 years. With NP/BPA data, ML models identified >99% of 222 converters.

This study highlights the strengths of NP/BPA data. Multidimensional cognitive features may enhance sensitivity to early changes predictive of incipient dementia.

Cognitive symptoms are common in functional neurological disorder (FND), yet evidence of impaired neurocognitive test performance is variable. We aimed to assess self-reported cognitive symptoms, neurocognitive test performance, and metacognitive confidence in patients with functional seizures (FS) and functional motor symptoms (FMS).

Participants with FS (n = 50) and FMS (n = 50) were compared to age- and gender-matched healthy controls (HC, n = 50), and clinical controls with depression and/or anxiety disorders (CC, n = 50). The Cambridge Neuropsychological Test Automated Battery was used to examine response speed, working memory, executive functions, and social–emotional processing, with subjective confidence rated for each test. Intellectual functioning, performance validity, and self-reported cognitive symptoms were also assessed.

The FND groups reported elevated cognitive symptoms compared to HC and CC (p-values<0.001). Impaired performance was demonstrated in both FND groups on tests of sustained attention (p-values = 0.03- < 0.001) and set-shifting (p-values = 0.01–0.001). Performance validity was comparable between groups (p = 0.64). The FND groups reported reduced post-diction confidence for sustained attention (p < 0.001). Executive performance deficits correlated with reduced test-specific confidence in FS/FMS (p-values = 0.02- < 0.001). In FMS, post-diction confidence for sustained attention performance correlated negatively with cognitive symptoms (p = 0.002). Cognitive symptoms were associated with psychological/physical symptom load, quality-of-life, and/or general functioning in FND and CC groups (p-values = 0.04- < 0.001).

Patients with FS and FMS displayed localized deficits on tests of executive functioning, with reduced domain-specific metacognitive confidence, alongside significant cognitive symptoms. These neurocognitive features were associated with poorer clinical status, warranting interventions targeting cognitive control and/or cognitive symptoms in everyday life.

The International Neuropsychological Society (INS) Justice and Equity Subcommittee initiated a survey of neuropsychological academic training programs, clinical practices, and research across Africa, examining respondents’ interest in collaboration and their views on resources needed to advance the field.

This quantitative, cross-sectional study employed chain-referral sampling at higher education institutions identified via uniRank. Of the 1,244 institutions screened, 241 offered psychology or psychiatry coursework. A multilingual cover letter and survey link (English, Swahili, Arabic, French, Portuguese, Spanish) were distributed, yielding 42 respondents from 17 of 54 countries (≈31.5% country response rate).

Most respondents were clinical psychologists or neuropsychologists and reported 1–5 neuropsychologists per country. Neuropsychologists’ roles included cognitive assessment, research, teaching, and assisting in neurological diagnoses, primarily using tests developed outside Africa. Current research centered on the neuropsychological effects of psychiatric disorders, infectious diseases (e.g., HIV, cerebral malaria), and neurodevelopmental disorders, with future focus areas identified as traumatic brain injury and epilepsy. Educational and training opportunities remain limited. Key barriers to program development included insufficient numbers of trained neuropsychologists, clinical training sites, and employment prospects. Despite this, there is strong interest in collaboration to accelerate the development of neuropsychology and neurosciences, given the heavy burden of neurological disease.

To foster growth, efforts must target the creation of academic and clinical training pathways and the adaptation, standardization, and norming of assessment tools tailored to African populations. There exist ample impactful avenues for individual and organizational collaboration or support to further the global development of neuropsychology.

Bipolar disorder and attention-deficit/hyperactivity disorder (ADHD) share overlapping clinical symptoms and cognitive deficits. Up to 20% of individuals with bipolar disorder also meet the criteria for ADHD (bipolar disorder + ADHD), a subgroup that may experience greater cognitive and functional impairments than those with bipolar disorder or ADHD alone.

To (a) characterise cognitive profiles in bipolar disorder, ADHD and bipolar disorder + ADHD compared with healthy controls; (b) examine associations between cognitive and occupational functioning; and (c) investigate associations between cognitive function and polygenic scores (PGS) for bipolar disorder, ADHD and educational attainment.

In this observational study, 477 euthymic individuals with bipolar disorder (including 78 with bipolar disorder + ADHD), 59 adult individuals with ADHD and 171 healthy controls completed standardised neuropsychological testing. Full-scale IQ and final school grades indexed current and premorbid cognitive ability, respectively. Occupational functioning was evaluated both cross-sectionally and through 5 years of registry-based follow-up. PGS were available for 295 bipolar disorder and 132 healthy control participants.

All patient groups performed significantly below healthy controls across most cognitive domains. Bipolar disorder + ADHD exhibited poorer working memory than bipolar disorder (d = −0.35, 95% CI [−0.66, −0.03]). Occupational function was lowest in bipolar disorder + ADHD (versus bipolar disorder, d = −0.44, 95% CI [−0.69, −0.19]). In bipolar disorder, poorer executive function (standardised regression coefficient (standβ) = 0.20, 95% CI [0.09, 0.31]) and older age predicted reduced occupational outcomes. PGS for educational attainment was associated positively with cognition in both bipolar disorder (working memory: standβ = 0.19, 95% CI [0.08, 0.30]) and healthy controls (executive function: standβ = 0.20, 95% CI [0.09, 0.32]), while PGS for bipolar disorder or ADHD were not significantly associated with cognitive performance.

Individuals with bipolar disorder + ADHD showed disproportionate working memory and functional impairment compared with bipolar disorder or ADHD alone. Executive function is a key predictor of occupational outcomes in bipolar disorder and is partly shaped by genetic propensity for educational attainment. These findings highlight the importance of considering ADHD comorbidity and cognitive profiles when evaluating functional prognosis and tailoring interventions.

Substance use has consistently been linked with cognitive impairments. However, most previous studies have focused on highly selective samples of individuals with chronic substance use disorders and have typically relied solely on self-reports. The associations between recreational use patterns of single or multiple substances and cognitive functioning in representative samples remain unclear.

We measured over 100 substances and their metabolites over the past 3 months in 850 young adults (48.6% female, Mage = 24.4) from a community-based cohort, using quantitative hair analysis. We assessed sustained attention, working memory, declarative memory, and a total cognitive performance index using the Cambridge Neuropsychological Test Automated Battery. We regressed cognition on hair substance concentrations, adjusting for sex, household socioeconomic status, migration background, education, gaming experience, and self-reported daily tobacco and alcohol use.

In their hair samples, 386 (45.5%) participants tested positive for at least one psychotropic substance other than alcohol and nicotine. Higher hair concentrations of Δ9-tetrahydrocannabinol (Cohen’s d = 0.40) and codeine (d = 0.22) were associated with lower sustained attention; higher concentrations of ketamine (d = 0.59) with worse declarative memory. Higher hair concentrations of cocaine and a higher polysubstance use severity index (PSUSI) were associated with both reduced attention (cocaine: d = 0.21; PSUSI: d = 0.30) and declarative memory (cocaine: d = 0.20; PSUSI: d = 0.29).

In this community sample of young adults, substance use was highly prevalent and associated with reduced cognitive performance, with small-to-moderate effect sizes. Cognitive consequences of recreational substance use may have been previously underestimated.

Language deficits are frequently described by patients with multiple sclerosis (MS); however, objective characterization remains somewhat limited due to its omission from standard MS cognitive evaluation and the inconsistent findings that arise from current language measures.

To establish alternative approaches to characterizing single-word level language in MS, this study (i) validates the Sydney Language Battery (SYDBAT) visual confrontation naming subtest and (ii) examines the insights provided by examining naming errors and latencies.

40 MS patients from Royal Melbourne Hospital’s Cognitive Neuroimmunology Clinic and 40 matched controls completed a series of neuropsychological tests, including the SYDBAT and ‘gold standard’ confrontation naming task, the Boston Naming Test (BNT). Error types and latencies on the SYDBAT were extracted from assessment audio recordings.

SYDBAT and BNT scores were highly correlated (r = 0.81, p < .001) and these tasks reported comparable receiver operating characteristic curves (p = .091). Latency analysis captured lexical retrieval difficulties, with patients displaying significantly longer mean latencies than controls on the SYDBAT (p = .012, β = 0.54).

These findings support the validity of the SYDBAT and value of the latency analysis in characterizing language impairment in MS. Use of the SYDBAT and latency considerations contribute to a broader assessment with a briefer administration time compared to gold-standard evaluation. The study thereby offers clinicians an enhanced toolkit to more effectively and appropriately evaluate language functioning and supplement standard cognitive evaluation in this population.

There is no consensus on core curriculum content for neuropsychiatry and behavioural neurology training and the breadth of topic coverage is poorly understood. Using a scoping review, we identified 23 unique syllabuses from Australia, Argentina, Chile, Mexico, New Zealand, South Africa, the USA and the UK, and one explicitly international in scope.

Syllabuses addressed a wide range of neuropsychiatric conditions, encompassing not only overlapping psychiatric and neurological disorders, but also functional, behavioural and cognitive disorders. Training integrated knowledge from neuropsychology, philosophy, ethics and social sciences. Core elements included clinical assessment, intervention skills and case management in social and institutional settings. Neuropsychiatry and behavioural neurology training integrates a broad spectrum of knowledge and skills, is aimed at a range of professionals and is delivered as both specialist training and embedded components within core training.

The core components of neuropsychiatry curricula identified in this study provide a foundation for institutions to develop or enhance their neuropsychiatry training programs.

Body-focused repetitive behaviors (BFRBs) include activities like hair pulling and skin-picking that can lead to functional impairment. The neurocognitive underpinnings of BFRBs remain unclear, with inconsistent findings across domains.

This online study aimed to investigate the neuropsychological capacities of individuals with self-reported BFRBs. We administered the Go/No-Go test to assess inhibitory control and attention and the Verbal Learning and Memory Test to evaluate learning, recall, and memory confidence. From the 2,129 participants who entered the survey, 412 individuals with self-reported BFRBs and 412 matched controls from the general population were included. Drop-out was high.

Individuals with BFRBs showed no inhibitory deficits on the Go/No-Go test but made fewer hits on the Go trials compared to controls, indicating attentional lapses. Regarding memory, only immediate recall was worse in the BFRB sample. Controls were biased toward being more confident. When we divided the sample by impairment (>1 SD below the mean of controls), a minority of the BFRB group showed deficits in attention and immediate recall.

Our findings suggest that neurocognitive deficits are not prevalent in BFRB, affecting less than 20% of our sample. Yet, attentional problems in a subgroup of individuals with BFRB highlights the need to study heterogeneity within BFRBs. Potential moderators such as motivation, stress, and self-stigma remain to be explored. Our findings must be interpreted with caution given the study’s limited generalizability due to its online format, high drop-out rate, and absence of independent diagnostic confirmation.

The National Institutes of Health (NIH) Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER) is a validated laptop-based battery of executive functioning tests. A modified tablet version of the EXAMINER was developed on the UCSF Tablet-based Cognitive Assessment Tool (TabCAT-EXAMINER). Here we describe the battery and investigate the reliability and validity of a composite score.

A diagnostically heterogeneous sample of 2135 individuals (mean age = 65.58, SD = 16.07), including controls and participants with a variety of neurodegenerative syndromes, completed the TabCAT-EXAMINER. A composite score was developed using confirmatory factor analysis and item response theory. Validity was evaluated via linear regressions that tested associations with neuropsychological tests, demographics, clinical diagnosis, and disease severity. Replicability of cross-sectional results was tested in a separate sample of participants (n = 342) recruited from a frontotemporal dementia study. As this separate sample also collected longitudinal TabCAT-EXAMINER measures, we additionally assessed test-retest reliability and associations between baseline disease severity and changes in TabCAT-EXAMINER scores.

The TabCAT-EXAMINER score was normally distributed, demonstrated high test-retest reliability, and was associated in the expected directions with independent tests of executive functioning, demographics, disease severity, and diagnosis. Greater baseline disease severity was associated with more rapid longitudinal TabCAT-EXAMINER decline.

The TabCAT-EXAMINER is a tablet-based executive functioning battery developed for observational research and clinical trials. Performance can be summarized as a single composite score, and results of this study support its reliability and validity in cognitive aging and neurodegenerative disease cohorts.

We examined cognitive performance in children with complicated mild-severe traumatic brain injury (TBI) versus orthopedic injury (OI) using the National Institutes of Health Toolbox Cognitive Battery (NIH TB-CB).

We recruited children ages 3–18, hospitalized with complicated mild-severe TBI (n = 231) or orthopedic injury (OI, n = 146). Cognition was assessed using the NIH TB-CB at six and twelve months post-injury. We used linear mixed models to assess associations of injury group (TBI versus OI), timepoint (six versus twelve months), and the interaction of injury group and timepoint with NIH TB-CB Total Cognition, Fluid Cognition, and Crystallized Cognition composites, adjusted for sex and socioeconomic status (SES), with Bonferroni correction. We evaluated differences in cognition stratified by injury severity (complicated mild–moderate TBI vs severe TBI) using ANCOVA, adjusting for sex and SES.

Neither injury group nor the interaction of group and timepoint were associated with Total (group: p = 0.50; timepoint*group: p = 0.185), Fluid (group: p = 0.297; timepoint*group: p = 0.842), or Crystallized Cognition (group: p = 0.039; timepoint*group: p = 0.017). However, children with severe TBI performed significantly worse on Fluid and Total Cognition than children with complicated mild–moderate TBI at six months (Fluid: p = 0.004, partial η2 = 0.06, moderate effect, Total: p = 0.012 partial η2 = 0.03, small–moderate effect) and twelve months post-injury (Fluid: p < 0.001, partial η2 = 0.11, moderate–large effect, Total: p = 0.002, partial η2 = 0.06, moderate effect).

The NIH TB-CB detects worse cognitive functioning in children with severe TBI six-twelve months post-injury, largely driven by differences in Fluid Cognition. Our findings suggest the NIH TB-CB may be suitable for monitoring cognition in children with TBI.

Pediatric cancer survivors are at increased risk for neurocognitive challenges that can impact academic achievement and attainment. Educational supports via accommodations or special education can promote better outcomes for these youth; however, barriers often stand in the way of appropriate supports being implemented. Neuropsychological evaluation reports highlight a child’s neurocognitive strengths and needs, but an additional tool to assist parents and educators in understanding the extent to which a child’s neurocognitive needs are addressed by their educational supports may help ensure appropriate supports.

The present study piloted a novel neurocognitive needs-to-educational supports alignment rubric in a referred sample of pediatric survivors of cancer, bone marrow transplant, and cancer predisposition syndromes (i.e., neurofibromatosis).

Inter-rater reliability across disciplines was satisfactory. Among school-aged patients who were attending public school (n = 90), mean needs-to-supports alignment was 20.3%, indicating that on average, referred patients were receiving minimal classroom supports addressing identified neurocognitive needs. Among the 42.9% with a formal support plan, proportion of needs met by a support rose to only 47%, indicating that in spite of some recognition of patient needs, supports remain inadequate to the breadth of patient needs.

This alignment tool can assist parents and educators in better tailoring a child’s educational supports to meet their needs, serve as a communication tool between healthcare and education teams, and provide a quantitative metric for evaluating educationally focused interventions (e.g., school liaison programming) in youth with a variety of chronic health conditions and developmental disabilities.