Children and adolescents with epilepsy are known to demonstrate executive function dysfunction, including working memory deficits and planning deficits. Accordingly, assessing specific executive function skills is important when evaluating these individuals. The present investigation examined the utility of two measures of executive functions-the Tower of London and the Behavioral Rating Inventory of Executive Functioning (BRIEF)-in a pediatric epilepsy sample. Ninety clinically referred children and adolescents with seizures were included. Both the Tower of London and BRIEF identified executive dysfunction in these individuals, but only the Tower of London variables showed significant relations with epilepsy severity variables such as age of epilepsy onset, seizure frequency, number of antiepileptic medications, etc. Further, the Tower of London and BRIEF variables were uncorrelated. Results indicate that objective measures of executive function deficits are more closely related to epilepsy severity but may not predict observable deficits, as reported by parents. Comprehensive evaluation of such deficits, therefore, should include both objective measures as well as subjective ratings from caregivers.

The emotional deficit perspective predicts that youth with psychopathic traits are relatively unresponsive to negative affective cues and display smaller attentional biases for affective stimuli following negative experiences than youth without psychopathic traits. In contrast, because the negative preception hypothesis predicts that youth with psychopathic traits learn to tune out negative affective experiences, it predicts that such youth exhibit greater attentional biases away from sadness-related stimuli following negative experiences than youth without psychopathic traits, and that these biases increase with age. This study was designed to test the conflicting predictions of the emotional deficit perspective and the negative preception hypothesis by administering an affective dot probe task to 135 male and female detained adolescents (13.06 to 17.62 years of age) following a frustration experience. Analyses showed that age moderated the impact of psychopathic traits: as age increased, higher levels of the affective-interpersonal component of psychopathy were associated with increasing attentional bias away from both sadness-related and happiness-related stimuli. These findings provide initial evidence corroborating the negative preception hypothesis in youth with psychopathic traits.

The assessment of effort is an important aspect of a comprehensive neuropsychological evaluation, as this can significantly impact data interpretation. While recent work has validated the appropriateness of adult-derived cutoffs for standalone effort measures in younger populations, little research has focused on embedded effort measures in children. The present study includes 54 clinically referred children and adolescents (32 males/22 females; aged 6-17) with a confirmed diagnosis of epilepsy. Reliable Digit Spans (RDSs) were calculated and the Test of Memory Malingering (TOMM) was administered in the context of a comprehensive neuropsychological evaluation. Using a previously published RDS cutoff of ≤6, a pass rate of only 65% was obtained, well below the recommended 90% pass rate for an effective effort index. In contrast, when adult criteria were used on TOMM Trial 2, a 90% pass rate was observed. RDS scores were significantly correlated with IQ estimates (r = .59, p < .001) and age (r = .61, p < .001). The difference between RDS and the TOMM on the participant outcome was statistically significant (χ(2) = 9.05, p = .003). These results suggest that RDS appears to yield a large number of false positives and, therefore, may be of limited utility in detecting poor effort in a pediatric epilepsy population. These findings likely extend to other pediatric populations that are known to have significant cognitive loss.

Although recent studies have demonstrated the utility of assessing psychopathic traits in adolescent males, there is substantially less evidence on the utility of assessing psychopathic traits in adolescent females. This study investigated the reliability and construct validity of the Psychopathy Checklist: Youth Version (PLC:YV) among a sample of 80 incarcerated adolescent females. Reliability analyses indicated high interrater agreement and internal consistency for PCL:YV scores. Consistent with research on adults and adolescent male offenders, psychopathic traits were associated with a greater number of conduct disorder and alcohol dependence symptoms, earlier onset of criminal behavior, a propensity toward institutional violence, and interpersonal behaviors associated with psychopathy. Consistent with some prior studies of youth, there were no negative relationships between PCL:YV scores and internalizing disorder diagnoses and some positive associations between psychopathy ratings and negative affectivity. Results suggest that assessing psychopathic traits in adolescent females provides meaningful information regarding criminal behavior, patterns, and personality traits in youth.

Executive function deficits are common in children and adolescents with epilepsy. Though the Wisconsin Card Sorting Task (WCST) is often considered the "gold standard" for executive function assessment, its sensitivity-particularly in the case of the 64-card version (WCST-64)-is insufficiently established in pediatric samples, including children and adolescents with epilepsy. The present investigation assesses the sensitivity of the WCST-64 in children and adolescents with epilepsy in comparison to another measure: the Tower of London - Drexel Version (TOL-DX). A total of 88 consecutively referred children and adolescents with epilepsy were administered both the WCST-64 and TOL-DX as part of a comprehensive neuropsychological evaluation. The sensitivity of WCST-64 and TOL-DX variables were established and relations with epilepsy severity measures and other executive function measures were assessed. Of the WCST-64 variables, Perseverative Responses is the most sensitive, but detected executive function impairment in only 19% of this clinically referred sample; in contrast, the TOL-DX Rule Violations detected executive function impairment in half of the sample. Further, TOL-DX performances are more strongly related to epilepsy severity variables and other executive function measures in comparison to the WCST-64. Despite its popularity amongst clinicians, the WCST-64 is not as sensitive to executive dysfunction in comparison to other measures of comparable administration time, such as the TOL-DX.