Although performance validity testing is becoming fairly routine in clinical settings, research protocols involving neuropsychological tests infrequently include assessments of performance validity. The current study utilized an embedded measure of effort over two administrations of CNS Vital Signs to determine the frequency of poor effort in non-clinical healthy undergraduate students participating in a research study for course credit. Results indicate that more than 1 in 10 college students participating in a cognitive test battery for research showed test scores consistent with inadequate effort, which was associated with poor performance on testing across many domains. This conclusion was supported by poor performance on many other subtests. Healthy college students with suboptimal effort (n = 11) had an overall score in the 15th percentile on average compared to the 48th percentile in the rest of the students (n = 66). Those who failed validity indicators on the baseline administration were more likely to fail validity indicators on the repeat administration. Those who were tested in the morning were also more likely to fail validity indicators. The current study provides evidence for the potential limitations of conducting research using neuropsychological tests with healthy college student volunteers in the absence of performance validity testing. Revised college-level cutoffs are proposed.

The assessment of response validity is now considered an important and necessary component of neuropsychological evaluations. One way for assessing response validity is with performance validity tests (PVTs), which measure the degree of effort applied to testing to achieve optimal performance. Numerous studies have shown that normal and neurologically impaired children are capable of passing certain free-standing PVTs using adult cutoffs. Despite this, PVT use appears to be more common in adults compared to children. The overall purpose of this systematic review is to provide the reader with a general overview of the existing literature on PVTs in children. As part of this review, goals are to inform the reader why PVT use is not as prevalent in children compared to adults, to discuss why PVTs and related methods are important in pediatric cognitive evaluations, and to discuss practical limitations and future directions.

Composite cardiovascular risk scores can be useful indicators of future cognition. The development of a dementia risk score using similar risk factors could aid in the assessment and lifestyle interventions of persons at risk for dementia.

BackgroundThough meta-analyses of neuropsychological and social cognitive deficits in behavioral variant frontotemporal dementia (bvFTD) have been conducted, no study has comprehensively characterized and compared the neuropsychological, social cognitive, and olfactory profiles in the behavioral and language variants of FTD.MethodsOur search yielded 470 publications meeting inclusion criteria representing 11 782 FTD patients and 19 451 controls. For each domain, we calculated Hedges’ g effect sizes, which represent the mean difference between the patient and control group divided by the pooled standard deviation. The heterogeneity of these effects was assessed with Cochran's Q-statistic using a random-effects model. Meta-regressions were employed to analyze the influence of demographic and disease characteristics.ResultsThough semantic variant primary progressive aphasia patients showed the greatest impairment across all task types, the three groups showed similar cognitive effect sizes once contributions from the language subdomain were excluded from analysis. Contrary to expectation, the magnitude of deficits in executive functioning, social cognition and olfaction were comparable between the three subgroups. Among indices, a metric of executive errors distinguished the behavioral variant of FTD from the language phenotypes.ConclusionsThese data indicate that social cognitive and traditional executive functioning measures may not capture differences between FTD syndromes. These results have important implications for the interpretation of neuropsychological assessments, particularly when applied to the differential diagnosis of FTD. It is hoped that these findings will guide clinical and research assessments and spur new studies focused on improving the measurement of FTD syndromes.

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