Journal of clinical and experimental neuropsychology最新文献

{"title":"Sleep quality among women with head injuries due to intimate partner violence.","authors":"Sydney C Mueller, Sharon E Leong, Tk Logan, Justin E Karr","doi":"10.1080/13803395.2025.2486678","DOIUrl":"https://doi.org/10.1080/13803395.2025.2486678","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined the relationship between head injuries due to intimate partner violence (IPV) and sleep quality among women survivors of IPV.</p><p><strong>Method: </strong>Women were recruited from Kentucky courts after receiving protective orders against intimate partners, including women survivors of IPV with no head injury (<i>n</i> = 260; <i>M</i> = 31.8 years-old, SD = 9.7; 77.3% White) and women survivors with IPV-related head injuries (<i>n</i> = 244; <i>M</i> = 33.7 years-old, SD = 8.9; 88.1% White). Women completed in-person interviews, querying IPV severity, posttraumatic stress disorder (PTSD), pain severity, and sleep quality.</p><p><strong>Results: </strong>Women with IPV-related head injuries reported significantly worse sleep quality (<i>p</i> < .001, d = .63) than women survivors without head injuries. Analyses of components of sleep quality indicated that women with IPV-related head injuries had worse subjective sleep quality, longer sleep latency, shorter sleep duration, more sleep disturbances, greater sleep medication use, and more daytime dysfunction (all p-values<.001). The relationship between IPV-related head injury and sleep remained significant (<i>p</i> = .017, <math><msubsup><mi>η</mi><mi>p</mi><mn>2</mn></msubsup></math>=.01) after controlling for sociodemographics, IPV severity, PTSD, and pain.</p><p><strong>Conclusions: </strong>Compared to women survivors without head injuries, women with IPV-related head injuries, on average, had 10-minute longer sleep latency, slept 24 minutes less per night, had trouble falling asleep six more times per month, and used sleep medications more often. Further study of sleep quality among women with IPV-related head injuries and interventions to address poor sleep warrant future investigation.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural equation modeling of problematic internet use based on executive function, interpersonal needs, fear of missing out and depression.","authors":"Sana Alavinikoo, Mohammadreza Pirmoradi, Komeil Zahedi Tajrishi, Reza Arezoomandan","doi":"10.1080/13803395.2025.2480139","DOIUrl":"https://doi.org/10.1080/13803395.2025.2480139","url":null,"abstract":"<p><p>This study aimed to model PIU (Problematic Internet Use) based on executive functions, interpersonal needs, depression, and fear of missing out in adolescents aged 15 to 19 residing in Tehran. The sample size included 200 girls and boys selected through convenience sampling. Participants completed the computerized Wisconsin Card Sorting Test, Young's Internet Addiction Test (IAT), Beck Depression Inventory (BDI-II), Fear of Missing Out scale (FOMOS), and Interpersonal Needs Questionnaire (INQ). The data were analyzed using structural equation modeling with SPSS 26 and AMOS 24 software. According to the results, executive functions directly and through the mediating effects of depression and the fear of missing out, predicted PIU. Thwarted belongingness through the mediating effect of depression and the fear of missing out had an effect on PIU. Perceived burdensomeness predicted PIU directly and indirectly through the mediating effect of depression. The relationship between perceived burdensomeness and fear of missing out was not significant in this study. Overall, the fit indices indicated that the proposed research model is a good fit, and executive functions, depression, interpersonal needs, and fear of missing out can predict PIU. Moreover, executive functions, thwarted belongingness, and perceived burdensomeness were able to predict depression, and executive functions, along with thwarted belongingness, could predict fear of missing out.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-20"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of PCL-5 symptom validity indices in a Cross-Cultural Forensic Sample.","authors":"Ryan W Schroeder, Jack Spector, Makenna Snodgrass, Rachel K Bieu","doi":"10.1080/13803395.2025.2482650","DOIUrl":"https://doi.org/10.1080/13803395.2025.2482650","url":null,"abstract":"<p><strong>Introduction: </strong>Three symptom validity indices have recently been developed for the PTSD Checklist for DSM-5 (PCL-5). To date, these validity indices have been examined in North American research and clinical samples, generally with promising results. The current study aimed to cross-validate the symptom validity indices in a cross-cultural forensic sample.</p><p><strong>Method: </strong>Examinees (<i>N</i> = 79) were Balkan (Macedonian, Kosovar, and Serbian) contractors previously employed at United States military bases in Afghanistan and Iraq. Examinees claimed posttraumatic stress disorder (PTSD) secondary to alleged adverse experiences, and they were pursuing Federal Workers' Compensation claims for PTSD under the auspices of the Defense Base Act. In this study, validity status was determined via outcome on the Inventory of Problems-29.</p><p><strong>Results: </strong>There were no significant differences between most demographic and background variables when groups were divided by validity status. Conversely, scores on all validity tests were significantly different between the group of examinees who were likely credibly presenting and the group that was likely noncredibly responding; medium to large effect sizes were observed. Area under the curve statistics ranged from .73 to .77. Sensitivity rates ranged from .33 to .47 when specificity was held at .90 or higher.</p><p><strong>Conclusions: </strong>The findings converge well with prior research results, extending the use of PCL-5 symptom validity indices to a cross-cultural forensic sample.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and opportunities for a new era of neuropsychology training: a trainee survey study.","authors":"Joshua T Fox-Fuller, Amanda M Wisinger, Jacob W Koudys, Libby A DesRuisseaux, Brian Cerny, Taylor Rose Schmitt, Annalise Rahman-Filipiak, Kristen L Votruba","doi":"10.1080/13803395.2025.2464654","DOIUrl":"https://doi.org/10.1080/13803395.2025.2464654","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>Respondents who completed a majority of the survey (<i>n</i> = 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usability of the Mayo Test Drive remote self-administered web-based cognitive screening battery in adults aged 35-100 with and without cognitive impairment.","authors":"Jay S Patel, Teresa J Christianson, Logan T Monahan, Ryan D Frank, Winnie Z Fan, John L Stricker, Walter K Kremers, Aimee J Karstens, Mary M Machulda, Julie A Fields, Jason Hassenstab, Clifford R Jack, Hugo Botha, Jonathan Graff-Radford, Ronald C Petersen, Nikki H Stricker","doi":"10.1080/13803395.2025.2464633","DOIUrl":"10.1080/13803395.2025.2464633","url":null,"abstract":"<p><strong>Background: </strong>Mayo Test Drive (MTD): Mayo Test Development through Rapid Iteration, Validation and Expansion, is a web-based remote cognitive assessment platform for self-administered neuropsychological measures with previously demonstrated validity and reliability. We examined the usability of MTD and hypothesized that completion rates would be greater than 90%. We explored whether completion and participation rates differed by cognitive status and demographic factors.</p><p><strong>Methods: </strong>A total of 1,950 Mayo Clinic Study of Aging and Mayo Alzheimer's Disease Research Center participants (97% White, 99% Non-Hispanic) were invited to participate in this ancillary, uncompensated remote study. Most invitees were cognitively unimpaired (CU; <i>n</i> = 1,769; 90.7%) and 9.3% were cognitively impaired (CI; <i>n</i> = 181). Usability was objectively defined as the percentage of participants who completed a session after initiating a session for a given timepoint (i.e. completion rates).</p><p><strong>Results: </strong>Baseline session completion rates were 98.5% (<i>n</i> = 1199/1217 participants, mean age 71, SD = 12, range 35-100) and were comparable between CU (98.7%) and CI (95.0%) groups (<i>p</i> = .23). Completion rates did not significantly differ by age groups (<i>p</i> > .10) and remained high in individuals 80+ (<i>n</i> = 251, 97.3%). Participation rates were higher in the CU (<i>n</i> = 1142, 65.4%) versus CI (<i>n</i> = 57, 33.1%) group (<i>p</i> < .001); participants were younger and had more years of education (p's < .001). Adherence (i.e. retention) rate for a 7.5-month follow-up session was 89%. Average session duration was 16 min. Most participants used a personal computer (62.7%), followed by a smartphone (22.2%) or tablet (14.8%). Comments entered by 36.4% of participants reflected several themes including acceptability, face validity, usability, and comments informative for session context.</p><p><strong>Conclusions: </strong>MTD demonstrated high usability as defined by completion rates in this research sample that includes a broad age range, though participation rates are lower in individuals with cognitive impairment. Results support good adherence at follow-up, feasibility through mean session duration, and acceptability based on qualitative analysis of participant comments.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"67-89"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance invalidity in traumatic brain injury litigants with poor quality of education: a South African cross-cultural study.","authors":"Sharon Truter","doi":"10.1080/13803395.2025.2456045","DOIUrl":"10.1080/13803395.2025.2456045","url":null,"abstract":"<p><p><b>Introduction:</b> Performance invalidity is under-studied in countries outside of the United States of America (US), with non-English examinees and with those who have low levels or poor quality of education.<b>Method:</b> This cross-cultural neuropsychological study explored performance invalidity in South African adult traumatic brain injury (TBI) litigants (N = 100) who had 7‒12 years of poor quality of education and who spoke Afrikaans (n = 35), English (n = 9) or one of the indigenous African languages of Xhosa (n = 52), Swahili (n = 1), Pedi (n = 1), Sotho (n = 1) and Chichewa (n = 1) as first languages.<b>Results:</b> Using demographically appropriate cutoff scores for seven performance validity tests (PVTs), the prevalence of performance invalidity was calculated as being close to 30% for this group. Participants who failed zero or one PVT were categorized as performing validly, while those who failed ≥ 2 PVTs were categorized as performing invalidly, raising suspicion of feigned cognitive impairment. Only 9% of the participants failed three or more PVTs. Severity of brain injury and the demographic factors of age and level of education did not play a significant role in PVT failure.<b>Conclusion:</b> Considering the prevalence rate and that South African psychologists now have access to PVTs with demographically appropriated cutoff scores, South African psychologists no longer have an excuse not to include PVTs in their test batteries, even with examinees who have severe TBI.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"26-39"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trail making test - part B discontinuation is associated with worse performance across multiple cognitive domains, but not with psychological distress.","authors":"Ashley Heywood, Anna C Cichocki, Justin D Numerick, Madison M Dykins, Genevieve E Roth, Devin M Ulrich, Matthew S Phillips, Brian M Cerny, Gabriel P Ovsiew, Anthony D Robinson, Jason R Soble, Woojin Song, Neil H Pliskin, Kyle J Jennette","doi":"10.1080/13803395.2025.2464642","DOIUrl":"10.1080/13803395.2025.2464642","url":null,"abstract":"<p><strong>Objective: </strong>Individuals unable to complete neuropsychological tests within designated time limits (i.e. discontinue) are often excluded from statistical analysis. However, discontinuation may represent a meaningful clinical consideration. The present study investigated the clinical utility of discontinuation on the Trail Making Test Part B (TMT-B) as an indicator of cognitive functioning.</p><p><strong>Method: </strong>The sample included 137 patients (<i>n</i> = 90 completers; <i>n</i> = 47 non-completers) referred for comprehensive outpatient neuropsychological evaluation for primary memory complaints. Mann-Whitney U tests and chi-square tests compared the characteristics of patients who did complete the TMT-B to patients who did not by social demographics, neuropsychological test performance, health literacy/numeracy, and self-report measures of psychological symptoms and functional impairment.</p><p><strong>Results: </strong>TMT-B discontinuation was associated with significant differences across nearly all cognitive domains (p-adj <.01), including worse performance on measures of language, processing speed, verbal and visual learning and memory, executive functions, nondominant hand fine motor speed/dexterity, and visuoconstruction. Differences between individuals who discontinued TMT-B based on social demographics, psychological symptoms, functional abilities, performance validity measures, dominant hand fine motor speed/dexterity, and basic auditory working memory were nonsignificant.</p><p><strong>Conclusions: </strong>Discontinuation on TMT-B is associated with significantly worse cognitive performance across nearly all domains of neuropsychological performance. Discontinuation was not associated with any specific clinical diagnosis. Discontinuation could be an indicator of cognitive impairment and may reflect the unique value of the TMT-B as a screening tool for determining appropriate clinical assessment batteries.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"103-115"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the cognitive bias scale and cognitive bias scale of scales to other personality assessment inventory validity scales for detecting noncredible memory dysfunction in a clinical veteran sample.","authors":"Ryan W Schroeder, Rachel K Bieu, Makenna Snodgrass","doi":"10.1080/13803395.2025.2464635","DOIUrl":"10.1080/13803395.2025.2464635","url":null,"abstract":"<p><strong>Introduction: </strong>The Cognitive Bias Scale (CBS) and the three Cognitive Bias Scale of Scales (CB-SOS) were developed for the Personality Assessment Inventory (PAI) to assess for cognitive response bias in neuropsychological settings and populations. While cross-validation research to date has been supportive, the scales have yet to be validated in a clinically referred veteran sample.</p><p><strong>Method: </strong>Patients (<i>N</i> = 235) were clinically referred veterans who underwent neuropsychological evaluations. Individuals were classified into valid or invalid memory performance groups based on a criterion performance validity test. The CBS, the three CB-SOS, and multiple core and supplemental PAI symptom validity indices were examined.</p><p><strong>Results: </strong>Both the CBS and the three CB-SOS had large correlations with multiple over-report validity scales, and high concurrent elevation rates were observed across many of the over-report validity scales. The greatest area under the curve rates (i.e. .70 or above) were seen for the CBS, two of the CB-SOS, and one psychiatrically focused validity index. When maintaining specificity at ≥90%, the CBS and two of the CB-SOS demonstrated the best sensitivity rates (i.e. 28-29%).</p><p><strong>Conclusions: </strong>While the CBS and the three CB-SOS have strong positive relationships with psychiatrically-focused over-report validity indices, the CBS and two of the CB-SOS demonstrated the best classification accuracy rates for identifying noncredible memory impairment. The cutoff scores and classification accuracy findings are in line with other published research results, suggesting good generalization to a clinically referred veteran sample. Additional conclusions regarding other findings are drawn and discussed.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"12-25"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of self-rated resilience following traumatic brain injury.","authors":"Jacobus Donders, Acacia Redman, Ashley Trainor","doi":"10.1080/13803395.2025.2464638","DOIUrl":"10.1080/13803395.2025.2464638","url":null,"abstract":"<p><strong>Introduction: </strong>Resilience reflects the capacity of persons to continue to function in a positive way in the context of adverse conditions. Prior research has suggested that resilience may affect emotional adjustment and quality of life after traumatic brain injury (TBI). The purpose of this investigation was to determine to what extent self-rated resilience influences cognitive test performance after TBI.</p><p><strong>Method: </strong>We conducted a retrospective analysis of data collected during routine clinical care over a period of about 3 years at a regional rehabilitation facility. Participants included 100 adult persons with TBI (46% uncomplicated mild injury, 32% complicated mild injury and 22% severe injury). They had been clinically referred and seen for an outpatient neuropsychological evaluation within 1-36 months post injury. Main measures included the Connor-Davidson Resilience Scale-10 (CD - RISC-10), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Trail MakingTest (TMT).</p><p><strong>Results: </strong>Self-rated resilience, as reflected in CD - RISC-10 ratings, had strong negative correlations with symptoms of depression (PHQ-9) and anxiety (GAD-7). As expected, worse injury severity, older age and lower education level were associated with worse performance on both parts of the TMT (all <i>p</i>'s< .03). Importantly, beyond those influences, self-rated resilience was also positively associated with TMT performance. However, this was the case only in those who had threshold levels of normal resilience.</p><p><strong>Conclusions: </strong>Across the range of TBI severity, resilience as self-rated on the CD - RISC-10 is strongly related to subjective symptoms of anxiety and depression. It does not have a linear relationship with objective cognitive test performance. Instead, a minimum level of normal resilience is needed in order for it to support cognition after TBI. Findings of sub-threshold levels of resilience would support interventions to boost it and thereby potentially improve outcomes.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"90-102"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving beyond dichotomies: a case for logistic regression in neuropsychological evaluation.","authors":"Robert J Spencer, Sarah D Patrick, Michael T Ransom, Craig R Miller, Andrew C Hale","doi":"10.1080/13803395.2025.2478985","DOIUrl":"10.1080/13803395.2025.2478985","url":null,"abstract":"<p><strong>Introduction: </strong>Neuropsychologists often use continuously scored measures to create dichotomous cutoff scores for making decisions. Dichotomization allows test users to employ traditional diagnostic statistics, such as sensitivity and specificity, but this approach is conceptually and statistically limited. This study uses simulated data to explore problems with dichotomizing continuous data. We critically review commonly proposed solutions and illustrate how logistic regression (LR) can overcome these limitations. We explore practical issues including homogeneity and heterogeneity in forced dichotomization and how such problems are compounded by reporting multiple cutoff scores.</p><p><strong>Method: </strong>Using R, we simulated data for a hypothetical, normally distributed, cognitive screening test using 200 simulated participants. We set the probability of \"cognitive impairment\" at .5 and constrained the simulated screening test and impairment designation to correlate at <i>r</i> = .5. We described traditional diagnostic statistics of all cutoff scores and provided probabilities derived from descriptive observation and LR for each possible score.</p><p><strong>Results: </strong>Receiver operating characteristic area under the curve was .78 (95% CI: .71-.84), indicating the analyses were simulating an adequately accurate test. We illustrate how interpreting from groups created by cut scores leads to misleading classifications whereby disparate scores above or below a cut score are treated similarly, adjacent scores at the cutoff are treated as categorically distinct, and how offering multiple cutoff score compounds each of these problems. Although the idea of jettisoning categories in favor of examining observed data has appeal, such approaches are ill-advised because datasets often have peculiarities that can lead to misleading conclusions. Deriving probabilities from LR uses the full continuum of data and does not involve evaluators choosing from among cutoff options.</p><p><strong>Conclusions: </strong>We advocate using LR-based probability estimates instead of group-based cutoff scores when making dichotomous decisions from continuous data. These probability estimates can be directly applied to clinical and research practice.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}