Knowledge of patterns of neuropsychological performance among normal, healthy individuals is integral to the practice of clinical neuropsychology, because clinicians may not always account for intraindividual variability (IIV) before coming to diagnostic conclusions. The IIV was assessed among a sample of 46 healthy individuals with high average intelligence and educational attainment, utilizing a battery of neuropsychological tests, including the Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) and Wechsler Memory Scale, Fourth Edition (WMS-IV). The data indicated substantial variability in neurocognitive abilities. All participants were found to demonstrate scores considered impaired by at least 2 standard deviations (SDs). Despite adjusting for outliers, no participant produced a "normal" testing profile with an intraindividual maximum discrepancy (MD) of less than 1 SD in either direction. When WAIS-IV Full Scale IQ (FSIQ) was considered, participants generally demonstrated cognitive test scores ranging from 2 SDs less than to 1.5 SDs greater than their FSIQ. Furthermore, after demographic corrections, the majority (59%) of participants demonstrated at least 1 impaired cognitive test score, as defined by being 1 to 1.5 SDs below the mean. Overall, results substantiate the need for clinicians to consider FSIQ and educational attainment in interpretation of neuropsychological testing results, given the relevant commonality of "abnormal" test scores within this population. This may ultimately reduce the likelihood of making false-positive conclusions of impairment when educational attainment and intelligence are high, thus improving diagnostic accuracy.

This study provides valuable information regarding temporal relationships between TBI, sleep, and mental health problems among a combat military population. Findings have important implications from both prevention and clinical perspectives.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) people are sexual minorities and have higher rates of substance use disorders, mental illness, and trauma, which translates into compounded stigma for them. Compounded stigma is the additive and cumulative impact of belonging to one, or several, marginalized groups (eg, racial/ethnic minority, LGBTQ+) and also suffering from addiction, mental illness, and/or trauma. There are important interactions among these comorbidities, trauma, and sexual minority status that affect patient behavior, treatment planning, and treatment outcomes. This article presents a Venn diagram as a helpful clinical tool to visually illustrate the complex interactions of mental illness, addictions, trauma, and LGBTQ+ minority status for both health care providers and patients. Having an awareness and understanding of these important interactions can enhance patient rapport and treatment experience as well as treatment planning. [ Psychiatr Ann. 2019;49(10):446–452.]

Somatic symptom and other related disorders are chronic and difficult psychiatric presentations for providers to assess, diagnose, and treat and are seen more in the medical than psychiatric setting. Because patients with these disorders are commonly referred to the consultation-liaison service, it is important for hospital-based mental health professionals to understand these illnesses. Identifying and differentiating between these diagnoses requires an understanding of several factors, including the patient's medical history, circumstances that may be driving behavior, and careful evaluation of the patient's awareness of these factors. Such factors are also essential in directing treatment, which tends to be time intensive and prolonged. This article provides an illustrative case and general guidelines for the diagnosis and treatment of illnesses under the category of somatic symptoms and related disorders. [ Psychiatr Ann . 2017;47(4):184–191.]

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